# ACTIVE CARE SPINE AND SPORTS REHAB LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ActiveCare Spine & Sports Rehab
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780626440
- **Authorized official:** MR. RIK COUWENBERG PT (OWNER/MANAGING DIRECTOR/PT)
- **Authorized official phone:** (973) 366-4000

## Contact information

- **Practice address:** 600 MOUNT PLEASANT AVENUE, SUITE F, DOVER, NJ 07801
- **Practice address phone:** (973) 891-1080
- **Practice address fax:** (973) 891-1081
- **Mailing address:** 182 SOUTH ST, SUITE 7, MORRISTOWN, NJ 07960-5377
- **Mailing address phone:** (973) 540-0046
- **Mailing address fax:** (973) 540-0056

## Taxonomy

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

## Other

- **Enumeration date:** 06/10/2006
- **Last updated:** 06/03/2011