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Organization
ACTIVE PHYSICAL REHABILITATION
Active
Organization
ACTIVE PHYSICAL REHABILITATION
Active
Other names
Active Physical Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE WILLIS-MOORE (SUPERVISOR/BILLER)
(732) 223-6309
Entity
Organization
Contact information
Practice address
2516 HIGHWAY 35, MANASQUAN, NJ 08736-1925
(732) 223-6312
(732) 223-6409
Mailing address
2516 HIGHWAY 35, MANASQUAN, NJ 08736-1925
(732) 223-6309
(732) 223-6409
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
04/21/2021
Last updated
04/21/2021
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