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Individual

COLLEEN FAGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
111 W WATER ST, TOMS RIVER, NJ 08753-6407
(732) 473-9440
(732) 473-9455
Mailing address
202 HILLCREST AVE, NEPTUNE, NJ 07753-5731

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00929500
NJ

Other

Enumeration date
10/17/2006
Last updated
05/15/2008
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