Individual
AMY CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1615 ROGERS CT, WALL TOWNSHIP, NJ 07719-3863
(732) 397-5159
Mailing address
54 N PARK AVE, SHREWSBURY, NJ 07702-4413
(732) 852-5311
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00282000
NJ
Other
Enumeration date
04/19/2021
Last updated
04/19/2021
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