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Organization
EDGE WELLNESS AND PHYSICAL THERAPY, LLC
Active
Organization
EDGE WELLNESS AND PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE KIM PT, DPT, OCS (CEO)
(201) 785-7486
Entity
Organization
Contact information
Practice address
2 EXECUTIVE DR STE C1, FORT LEE, NJ 07024-3308
(201) 785-7486
(201) 771-3024
Mailing address
80 E RTE 4 STE 100, PARAMUS, NJ 07652-2647
(201) 845-3000
(201) 843-2035
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
06/30/2021
Last updated
06/30/2021
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