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Organization
HANOVER ORTHOPEDIC & SPORTS PHYSICAL THERAPY, LLC
Active
Organization
HANOVER ORTHOPEDIC & SPORTS PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH M SCOTT MPT (OWNER/MEMBER)
(201) 572-1012
Entity
Organization
Contact information
Practice address
565 ROUTE 10, WHIPPANY, NJ 07981-1513
(201) 572-1012
Mailing address
15 BUNKER HILL PL, WHIPPANY, NJ 07981-2216
(201) 572-1012
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10669911
CAQH
—
Enumeration date
01/03/2019
Last updated
01/03/2019
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