Organization
REACTIVE SPORTS PERFORMANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE WILLIAM NISIVOCCIA III PT, CSCS (OWNER)
(973) 769-2366
Entity
Organization
Contact information
Practice address
30 SEMINARY AVE, CHESTER, NJ 07930-2614
(973) 769-2366
Mailing address
30 SEMINARY AVE, CHESTER, NJ 07930-2614
(973) 769-2366
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
40QA00727500
NJ
Other
Enumeration date
10/14/2008
Last updated
10/14/2008
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