Organization
CORNERSTONE PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID DE LA FUENTE MS, PT, CSCS (PHYSICAL THERAPIST, PRESIDENT)
(732) 499-4540
Entity
Organization
Contact information
Practice address
152 CENTRAL AVE 2ND FLOOR, CLARK, NJ 07066
(732) 499-4540
(732) 499-4577
Mailing address
152 CENTRAL AVE 2ND FLOOR, CLARK, NJ 07066
(732) 499-4540
(732) 499-4577
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01170400
NJ
2251X0800X
Orthopedic Physical Therapist
40QA01170400
NJ
Other
Enumeration date
01/18/2007
Last updated
10/26/2007
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