Organization
ACTIVE FOR LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERRI O'CONNOR DPT (DOCTOR)
(908) 303-5846
Entity
Organization
Contact information
Practice address
20 W SPRING ST, SOMERVILLE, NJ 08876-1628
(908) 303-5846
Mailing address
20 W SPRING ST, SOMERVILLE, NJ 08876-1628
(908) 303-5846
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
40QA01255300
NJ
225X00000X
Occupational Therapist
46TR00658900
NJ
Other
Enumeration date
05/17/2018
Last updated
05/17/2018
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