Organization
HANDSOME PHYSICAL THERAPY WORKS LLC
Active
Other names
Lightport Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DE HOYOS DPT (DIRECTOR PHYSICAL THERAPIST)
(201) 377-8389
Entity
Organization
Contact information
Practice address
69 NICHOLAS AVE, WEST ORANGE, NJ 07052-2932
(201) 377-8389
Mailing address
69 NICHOLAS AVE, WEST ORANGE, NJ 07052-2932
(201) 377-8389
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
40Q01237600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12764132
CAQH
NJ
Enumeration date
01/28/2015
Last updated
01/28/2015
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