Organization
INNOVATIVE PHYSICAL REHAB AND WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE TAVARES (BILLING MANAGER)
(732) 317-4105
Entity
Organization
Contact information
Practice address
2204 ROUTE 18 NORTH, OLD BRIDGE, NJ 08857
(732) 317-4105
Mailing address
2204 ROUTE 18 NORTH, OLD BRIDGE, NJ 08857-2758
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
04/28/2021
Last updated
09/09/2021
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