Organization
POLARIS PHYSICAL THERAPY,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERTO YANEZ P.T. (PHYSICAL THERAPY DIRECTOR)
(856) 534-1052
Entity
Organization
Contact information
Practice address
284 DELSEA DR, SEWELL, NJ 08080-9469
(856) 534-1052
(856) 881-0077
Mailing address
PO BOX 64, SICKLERVILLE, NJ 08081-0064
(856) 534-1052
(856) 881-0077
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
40QA00393000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40QA00393000
PT LICENSE NUMBER
NJ
Enumeration date
12/24/2006
Last updated
08/22/2020
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