Organization
INNOVATIVE PHYSICAL THERAPY AND FITNESS CENTER INC
Active
Organization
INNOVATIVE PHYSICAL THERAPY AND FITNESS CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SURESH BABU PT,DPT,MS (PRESIDENT)
(732) 853-8177
Entity
Organization
Contact information
Practice address
3562 ROUTE 27, SUITE 124, KENDALL PARK, NJ 08824
(732) 853-8177
Mailing address
3562 ROUTE 27, SUITE 124, KENDALL PARK, NJ 08824
(732) 853-8177
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
40QA01115800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180947DBD
MEDICARE
—
Enumeration date
04/26/2012
Last updated
05/12/2021
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