Organization
DYNAMIC PHYSICAL THERAPY & SPORTS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HERNANDEZ PT (MANAGING DIRECTOR)
(201) 472-8828
Entity
Organization
Contact information
Practice address
407 39TH ST STE 301, UNION CITY, NJ 07087-4817
(201) 472-8828
Mailing address
407 39TH ST STE 301, UNION CITY, NJ 07087-4817
(201) 472-8828
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01620600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699143594
NPI NUMBER
NJ
Enumeration date
03/15/2016
Last updated
03/15/2016
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