Organization
VANGUARD PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL C IMPLICITO (OWNER)
(201) 845-6030
Entity
Organization
Contact information
Practice address
113 W ESSEX ST, SUITE 203, MAYWOOD, NJ 07607-1020
(201) 845-6030
(201) 845-6040
Mailing address
113 W ESSEX ST, SUITE 203, MAYWOOD, NJ 07607-1020
(201) 845-6030
(201) 845-6040
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
03/10/2015
Last updated
03/10/2015
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