Organization
LIVE 55X5
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE CLARKE (OWNER)
(201) 452-5007
Entity
Organization
Contact information
Practice address
201 BOULEVARD, POMPTON PLAINS, NJ 07444-1914
(201) 452-5007
Mailing address
201 BOULEVARD, POMPTON PLAINS, NJ 07444-1914
(201) 452-5007
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
05/17/2021
Last updated
05/17/2021
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