Individual
MRS. ELIZABETH BULOSAN DIVINAGRACIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
9 POST RD STE M12, OAKLAND, NJ 07436-1615
(201) 651-0062
(201) 651-7723
Mailing address
3 ROSE COURT 2ND FOR, BAYONNE, NJ 07002
(201) 993-9344
(201) 433-4772
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
40QA00953000
NJ
Other
Enumeration date
08/06/2007
Last updated
06/30/2016
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