Organization
92 BRICK ROAD OPERATING COMPANY LLC
Active
Other names
Marlton Rehabilitation Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRAD E. HOLLINGER (PRESIDENT)
(717) 591-5700
Entity
Organization
Contact information
Practice address
92 BRICK RD, MARLTON, NJ 08053-2177
(856) 988-8778
(856) 988-8254
Mailing address
92 BRICK RD, MARLTON, NJ 08053-2177
(856) 988-4100
(609) 261-7199
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001060000
AMERIHEALTH/KEYSTONE
NJ
Enumeration date
07/30/2007
Last updated
08/08/2013
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