Organization
MOMENTUM MEDICINE PLUS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN CARLOS CORNEJO DO (MEDICAL DIRECTOR)
(856) 552-2208
Entity
Organization
Contact information
Practice address
113 WHITE HORSE RD W, SUITE 7, VOORHEES, NJ 08043-3672
(856) 552-2208
Mailing address
113 WHITE HORSE RD W, SUITE 7, VOORHEES, NJ 08043-3672
(856) 552-2208
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
25MB08477000
NJ
Other
Enumeration date
02/19/2014
Last updated
02/19/2014
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