Organization
BACK TO LIFE WELLNESS & REHABILITATION
Active
Other names
Back To Life Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEGHAN RENDFREY MCDONOUGH DPT (ADMINISTRATIVE DIRECTOR)
(856) 424-6677
Entity
Organization
Contact information
Practice address
1930 MARLTON PIKE E, SUITE E27, CHERRY HILL, NJ 08003-2150
(856) 424-6677
(856) 489-1803
Mailing address
1930 MARLTON PIKE E, SUITE E27, CHERRY HILL, NJ 08003-2150
(856) 424-6677
(856) 489-1803
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
QA01105600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2356263000
AMERIHEALTH ID
NJ
01
—
2356263000
IND BCBS PERSONAL CHOICE
PA
Enumeration date
12/04/2006
Last updated
08/22/2020
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