Organization
ACTIVA REHABILITATION SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OLUFEMI DOSUNMU PT (PRESIDENT)
(973) 214-2315
Entity
Organization
Contact information
Practice address
331 CENTRAL AVENUE, 1, ORANGE, NJ 07050-2407
(973) 673-4600
(973) 673-4606
Mailing address
336 PARK AVE, ORANGE, NJ 07050-2827
(973) 673-4600
(973) 673-4606
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00445900
NJ
Other
Enumeration date
11/02/2012
Last updated
04/14/2015
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