Organization
ELITE PERFORMANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED NASSER PT (C0-OWNER)
(908) 419-4202
Entity
Organization
Contact information
Practice address
121 N NEWPORT AVE, VENTNOR CITY, NJ 08406-2105
(908) 419-4202
Mailing address
121 N NEWPORT AVE, VENTNOR CITY, NJ 08406-2105
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
40QA01103700
NJ
Other
Enumeration date
06/24/2011
Last updated
06/24/2011
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