Organization
JAG-ONE PHYSICAL THERAPY, LLC
Active
Other names
Jag Physical Therapy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
LUANN M TEETSELL (CREDENTIALING MANAGER)
(718) 844-5350
Entity
Organization
Contact information
Practice address
34 MOUNTAIN BLVD BLDG C, WARREN, NJ 07059-2640
(908) 222-0515
(908) 222-0516
Mailing address
900 ROUTE 9 N, WOODBRIDGE, NJ 07095-1025
(201) 801-7141
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
12/10/2018
Last updated
08/06/2019
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