Individual
GREGORY WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
96 PLEASANT HILL RD, CHESTER, NJ 07930-2135
(973) 989-7905
Mailing address
PO BOX 794, WHARTON, NJ 07885-0794
(973) 989-7905
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00216400
NJ
Other
Enumeration date
12/18/2013
Last updated
12/18/2013
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