Organization
THE PHYSICAL MEDICINE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARYL S MITRUSKA DC (PRESIDENT)
(732) 324-4300
Entity
Organization
Contact information
Practice address
453 AMBOY AVE, WOODBRIDGE, NJ 07095-2960
(732) 324-4300
(732) 324-8211
Mailing address
788 CONVERY BLVD, PERTH AMBOY, NJ 08861-2584
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NJ
Other
Enumeration date
07/11/2011
Last updated
02/19/2024
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