Organization
EVOLVE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDER CHARLES MS OTR/L (OWNER)
(862) 272-7504
Entity
Organization
Contact information
Practice address
18 OLIVER ST SUITE 101, NEWARK, NJ 07102
(862) 272-7504
(862) 206-8417
Mailing address
18 OLIVER ST SUITE 101, NEWARK, NJ 07102
(862) 272-7504
(862) 206-8417
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
—
225100000X
Physical Therapist
—
—
2251C2600X
Cardiopulmonary Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
225XH1200X
Hand Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
02/17/2020
Last updated
09/15/2021
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