Individual
MA GRACE ESPINAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15-01 BROADWAY, SUITE 30A, FAIR LAWN, NJ 07410-6003
(201) 703-7107
Mailing address
146 MADISON AVE, HASBROUCK HEIGHTS, NJ 07604-1309
(551) 358-7633
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
40QA01305000
NJ
Other
Enumeration date
11/17/2010
Last updated
11/17/2010
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