Organization
EDGE PRO SPORTS REHAB INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE KIM DPT (MANAGING DIRECTOR)
(201) 783-2332
Entity
Organization
Contact information
Practice address
407 SETTE DR, PARAMUS, NJ 07652
(201) 538-7131
Mailing address
80 E RTE 4 STE 100, PARAMUS, NJ 07652-2647
(201) 845-3000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01510100
NJ
225100000X
Physical Therapist
—
—
Other
Enumeration date
05/25/2018
Last updated
07/19/2021
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