Organization
SPORT AND SPINE PHYSICAL THERAPY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS MATTHEW DONOFRIO PT (PRESIDENT)
(201) 543-3902
Entity
Organization
Contact information
Practice address
103 N SUMMITT ST, TENAFLY, NJ 07670
(201) 816-0042
(201) 816-0043
Mailing address
595 WILDWOOD RD WEST, NORTHVALE, NJ 07647-1125
(201) 543-3902
(201) 750-2949
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
QA08961
NJ
Other
Enumeration date
04/17/2007
Last updated
10/25/2007
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