Organization
VICTORY PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL A WALTERS PT (OWNER)
(856) 223-8898
Entity
Organization
Contact information
Practice address
108 SWEDESBORO RD, SUITE 10, MULLICA HILL, NJ 08062-1800
(856) 223-8898
(856) 223-8799
Mailing address
108 SWEDESBORO RD, SUITE 10, MULLICA HILL, NJ 08062-1800
(856) 223-8898
(856) 223-8799
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
QA005763
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0332711000
PERSONAL CHOICE
NJ
01
—
2139173
AETNA
NJ
Enumeration date
09/21/2006
Last updated
08/22/2020
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