Organization
JW PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER WAIDELICH DPT (OWNER, PT, DPT)
(609) 658-9191
Entity
Organization
Contact information
Practice address
410 E AVE, CORONADO, CA 92118-1716
(609) 658-9191
Mailing address
410 E AVE, CORONADO, CA 92118-1716
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
06/03/2018
Last updated
06/03/2018
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