Organization
CREATE YOUR CORE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER PENN (PHYSICAL THERAPIST)
(908) 510-0290
Entity
Organization
Contact information
Practice address
44 LAKESIDE DR S, PISCATAWAY, NJ 08854-5104
(908) 510-0290
Mailing address
44 LAKESIDE DR S, PISCATAWAY, NJ 08854-5104
(908) 510-0290
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
09/17/2019
Last updated
09/17/2019
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