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Individual

ELEANOR C REGISTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT,DPT

Contact information

Practice address
1719 MAIN ST, LAKE COMO, NJ 07719-3097
(732) 894-9200
(732) 894-9202
Mailing address
1719 MAIN ST, LAKE COMO, NJ 07719-3097
(732) 894-9200
(732) 894-9202

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01859200
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
40QA01859200
PT LICENSE
NJ
Enumeration date
06/10/2019
Last updated
06/10/2019
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