Organization
THERASPORT PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PERNO DPT (OWNER/PHYSICAL THERAPIST)
(856) 256-8393
Entity
Organization
Contact information
Practice address
14 PARKE PLACE BLVD, SUITE D, SEWELL, NJ 08080-2661
(856) 256-8393
Mailing address
14 PARKE PLACE BLVD, SUITE D, SEWELL, NJ 08080-2661
(856) 256-8393
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
073598
PTAN
NJ
Enumeration date
05/15/2007
Last updated
01/31/2022
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