Organization
INNOVATIVE JOGO PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE TAVARES (BILLING MANAGER)
(732) 415-1600
Entity
Organization
Contact information
Practice address
2204 ROUTE 18 N, OLD BRIDGE, NJ 08857-3473
(732) 415-1600
Mailing address
2204 ROUTE 18 N, OLD BRIDGE, NJ 08857-3473
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
10/30/2023
Last updated
08/01/2024
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