Individual
MR. JOHANNS MAURICIO GAMMEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
251 ROCK RD, GLEN ROCK, NJ 07452-1745
(201) 445-0900
Mailing address
52 ANDOVER TER, GLEN ROCK, NJ 07452-3719
(551) 579-3588
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00260000
NJ
Other
Enumeration date
11/15/2006
Last updated
04/12/2012
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