# HANOVER ORTHOPEDIC & SPORTS PHYSICAL THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710450671
- **Authorized official:** KEITH M SCOTT MPT (OWNER/MEMBER)
- **Authorized official phone:** (201) 572-1012

## Contact information

- **Practice address:** 565 ROUTE 10, WHIPPANY, NJ 07981-1513
- **Practice address phone:** (201) 572-1012
- **Mailing address:** 15 BUNKER HILL PL, WHIPPANY, NJ 07981-2216
- **Mailing address phone:** (201) 572-1012

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 01/03/2019
- **Last updated:** 01/03/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 10669911 | CAQH | — |