# DIAGNOSTIC REHABILITATION SPECIALIST

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

## Provider details

- **NPI number:** 1982778908
- **Authorized official:** MR. JAMES BRYAN GLENN (PRESIDENT)
- **Authorized official phone:** (856) 691-5255

## Contact information

- **Practice address:** 44 S STATE ST, VINELAND, NJ 08360-4851
- **Practice address phone:** (856) 691-5255
- **Practice address fax:** (856) 691-5241
- **Mailing address:** 44 S STATE ST, VINELAND, NJ 08360-4851
- **Mailing address phone:** (856) 691-5255
- **Mailing address fax:** (856) 691-5241

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/20/2006
- **Last updated:** 08/22/2020