Organization
REVOLUTIONARY REHAB WELLNESS CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL MERCADO PT (PRESIDENT)
(201) 438-4400
Entity
Organization
Contact information
Practice address
138 PARK AVE, EAST RUTHERFORD, NJ 07073-1855
(201) 438-4400
(201) 203-1748
Mailing address
138 PARK AVE, EAST RUTHERFORD, NJ 07073-1855
(201) 438-4400
(201) 203-1748
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
40QA00805300
NJ
Other
Enumeration date
06/12/2014
Last updated
06/12/2014
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