Organization
EASTERN THERAPEUTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINIKI WHITE (MEMBER)
(609) 949-1597
Entity
Organization
Contact information
Practice address
309 FELLOWSHIP RD, SUITE 200, MOUNT LAUREL, NJ 08054-1234
(609) 949-1597
Mailing address
PO BOX 12531, JACKSONVILLE, NC 28546-2531
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0450135849
NJ
Other
Enumeration date
02/01/2017
Last updated
02/01/2017
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