Individual
JOHN JOSEPH THIEVON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
605 MAIN ST, HACKENSACK, NJ 07601-5914
(201) 881-7321
Mailing address
605 MAIN ST, HACKENSACK, NJ 07601-5914
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01767400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22-3033287
OUT-PATIENT PHYSICAL THERAPY
NJ
Enumeration date
12/04/2017
Last updated
12/04/2017
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