Organization
SPINE & SPORTS MEDICINE OF TOMS RIVER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE FULLAWAY DPT (PARTNER)
(732) 714-0070
Entity
Organization
Contact information
Practice address
367 LAKEHURST RD, TOMS RIVER, NJ 08755
(732) 573-6235
(732) 504-7676
Mailing address
367 LAKEHURST RD, TOMS RIVER, NJ 08755-7330
(732) 714-0070
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
171100000X
Acupuncturist
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Enumeration date
05/23/2018
Last updated
05/09/2024
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