Organization
TIER 1 FITNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTWUAN DYER JR. (MEMBER)
(856) 425-9220
Entity
Organization
Contact information
Practice address
5921 WESTFIELD AVE, PENNSAUKEN, NJ 08110-1841
(856) 425-9220
Mailing address
5921 WESTFIELD AVENUE, PENNSAUKEN, NJ 08110
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
09/30/2017
Last updated
09/30/2017
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