Organization
BEACON PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY SCOTT DAVIS PHYSICAL THERAPIST (OWNER)
(973) 233-1514
Entity
Organization
Contact information
Practice address
34 YALE STREET, MAPLEWOOD, NJ 07040
(973) 762-1988
Mailing address
45 CHURCH STREET, APT C 17, MONTCLAIR, NJ 07042
(973) 233-1514
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00979300
NJ
Other
Enumeration date
10/12/2006
Last updated
08/22/2020
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