Individual
DEVON WILLIAM MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
622 EAGLE ROCK AVE, WEST ORANGE, NJ 07052-2994
(973) 669-0078
(973) 669-1113
Mailing address
981 US HIGHWAY 22 FL 2, BRIDGEWATER, NJ 08807-2946
(201) 801-7141
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00397200
NJ
Other
Enumeration date
10/05/2022
Last updated
10/05/2022
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