Organization
DYNAMIC PHYSICAL THERAPY AND WELLNESS LLC
Active
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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