Organization
DR. COACH KELLI PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIANNE JOSEPHSEN (OWNER)
(201) 396-9712
Entity
Organization
Contact information
Practice address
185 FAIRFIELD AVE STE 1A, WEST CALDWELL, NJ 07006-6417
(201) 396-9712
Mailing address
185 FAIRFIELD AVE STE 1A, WEST CALDWELL, NJ 07006-6417
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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