Organization
ACTIVITY FIRST PHYSICAL THERAPY AND SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN LUIS GONZALEZ P.T. (OWNER)
(732) 544-0007
Entity
Organization
Contact information
Practice address
158 WYCKOFF RD, EATONTOWN, NJ 07724-1840
(732) 544-0007
(732) 544-0008
Mailing address
158 WYCKOFF RD, EATONTOWN, NJ 07724-1840
(732) 544-0007
(732) 544-0008
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00616100
NJ
Other
Enumeration date
10/17/2006
Last updated
03/11/2014
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