Individual
BLAKE O. WATERMAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
640 S WHITE HORSE PIKE, HAMMONTON, NJ 08037-2014
(609) 704-1980
(609) 704-9054
Mailing address
PO BOX 83, HAMMONTON, NJ 08037-0083
(609) 704-1980
(609) 704-9054
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00583400
NJ
Other
Enumeration date
06/08/2006
Last updated
07/08/2007
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