Organization
PERFORMANCE PHYSICAL MEDICINE & REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN M WRAITH D.C (PRESIDENT)
(973) 341-5253
Entity
Organization
Contact information
Practice address
18 FURLER ST, TOTOWA, NJ 07512-1802
(973) 341-5253
(973) 341-5254
Mailing address
18 FURLER ST, TOTOWA, NJ 07512-1802
(973) 341-5253
(973) 341-5254
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00297800
NJ
Other
Enumeration date
06/07/2012
Last updated
06/07/2012
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