Organization
DISTINCT PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YVONNE VAN BOCHOVE PT (OWNER)
(732) 890-4866
Entity
Organization
Contact information
Practice address
558 BUTTONWOOD DR, JACKSON, NJ 08527-4906
(732) 890-4866
Mailing address
558 BUTTONWOOD DR, JACKSON, NJ 08527-4906
(732) 890-4866
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00519800
NJ
Other
Enumeration date
05/28/2009
Last updated
03/02/2011
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