Individual
MISS KAREN JACKLYN ACQUAVIVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
7 ALASKA AVE, JACKSON, NJ 08527-1801
(732) 233-4876
Mailing address
7 ALASKA AVE, JACKSON, NJ 08527-1801
(732) 233-4876
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00167700
NJ
Other
Enumeration date
05/31/2007
Last updated
07/08/2007
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