Individual
DR. HEIDI A. QUACKENBOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
700 PASSAIC AVE, WEST CALDWELL, NJ 07006-6408
(973) 575-7576
(973) 575-7985
Mailing address
415 CLAREMONT AVE APT 1C, MONTCLAIR, NJ 07042-1815
(973) 233-1312
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
40QA01298900
NJ
2251X0800X
Orthopedic Physical Therapist
Primary
40QA01298900
NJ
Other
Enumeration date
12/02/2008
Last updated
12/02/2008
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