Organization
DYNAMIC PHYSICAL THERAPY AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER MERCADO (MANAGING DIRECTOR)
(201) 564-7515
Entity
Organization
Contact information
Practice address
185 CENTRAL AVE STE 311, EAST ORANGE, NJ 07018-3318
(201) 564-7515
(201) 564-7514
Mailing address
220 LIVINGSTON ST STE 108, NORTHVALE, NJ 07647-1739
(120) 189-5953
(201) 564-7514
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891017034
NPI
NJ
Enumeration date
06/07/2021
Last updated
06/07/2021
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