Individual
MR. DAN LISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
14 PARKE PLACE BLVD, SUITE D, SEWELL, NJ 08080-2661
(856) 256-8393
(856) 265-8390
Mailing address
22 ALTON WAY, SEWELL, NJ 08080-3114
(856) 381-7721
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00902500
NJ
2251X0800X
Orthopedic Physical Therapist
40QA00902500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2238845000
AMERIHEALTH
NJ
01
—
2439868
UNITED HEALTHCARE
NJ
01
—
P00162648
RAILROADMCR
NJ
Enumeration date
12/28/2006
Last updated
07/25/2018
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