Organization
DYNAMIC PHYSICAL THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAWN DAVIS A DPT (ADMINISTRATOR)
(908) 620-1991
Entity
Organization
Contact information
Practice address
313 E WESTFIELD AVE, ROSELLE PARK, NJ 07204-2317
(908) 620-1991
(908) 620-9777
Mailing address
313 E WESTFIELD AVE, ROSELLE PARK, NJ 07204-2317
(908) 620-1991
(908) 620-9777
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
02/23/2007
Last updated
08/22/2020
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