Organization
ACTIVE WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE CANNON PT (PHYSICAL THERAPIST/OWNER)
(609) 707-2856
Entity
Organization
Contact information
Practice address
6 COVENTRY CT, CHERRY HILL, NJ 08002-1519
(609) 707-2856
Mailing address
6 COVENTRY CT, CHERRY HILL, NJ 08002-1519
(609) 707-2856
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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