Individual
JUSTIN THOMAS MCTISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTD, OTR/L, CAPS
Contact information
Practice address
1050 US HIGHWAY 1, AVENEL, NJ 07001-1548
(732) 504-3649
(732) 564-9032
Mailing address
1050 US HIGHWAY 1, AVENEL, NJ 07001-1548
(732) 283-2663
(732) 283-2661
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR0097550
NJ
Other
Enumeration date
06/23/2021
Last updated
11/11/2021
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