Individual
MR. JASON JAMES SUPERNAVAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
291 HARDING HWY, SUITE A, CARNEYS POINT, NJ 08069-2229
(856) 299-9229
(856) 299-9226
Mailing address
54 MARYLAND AVE, PENNSVILLE, NJ 08070-1528
(856) 678-8078
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01075700
NJ
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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