Individual
DEVON ANNE FANELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1135 BROAD STREET, CLIFTON, NJ 07013
(973) 574-8585
(973) 574-8590
Mailing address
1135 BROAD STREET, CLIFTON, NJ 07013
(973) 574-8585
(973) 574-8590
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01449900
NJ
Other
Enumeration date
08/21/2012
Last updated
08/21/2012
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