Organization
WOODBURY PHYSICAL MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUY DAVID PISTILLI D.C. (MANAGER)
(856) 848-1515
Entity
Organization
Contact information
Practice address
223 S EVERGREEN AVE, WOODBURY, NJ 08096-2713
(856) 848-1515
(856) 845-7753
Mailing address
223 SOUTH EVERGREEN AVENUE, WOODBURY, NJ 08096-2713
(856) 848-1515
(856) 845-7753
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00365600
NJ
208100000X
Physical Medicine & Rehabilitation Physician
25MA03618000
NJ
225100000X
Physical Therapist
40QA00966600
NJ
Other
Enumeration date
06/13/2006
Last updated
12/19/2012
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