Organization
ALTIUS PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVAN BRACCONERI DPT (OWNER)
(845) 548-1641
Entity
Organization
Contact information
Practice address
52 PARK AVE STE A4, PARK RIDGE, NJ 07656-1277
(845) 548-1641
Mailing address
769 DRAKE LN, RIVER VALE, NJ 07675-6115
(845) 548-1641
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
07/01/2022
Last updated
10/03/2022
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