Individual
JAKE GROOTENBOER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
776 N RTE 17, PARAMUS, NJ 07652-3117
(201) 225-9222
(201) 225-9223
Mailing address
331 NEWMAN SPRINGS RD STE 220, RED BANK, NJ 07701-5792
(732) 807-0877
(201) 751-1680
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA02030000
NJ
Other
Enumeration date
09/02/2021
Last updated
08/15/2024
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