Individual
GREALITA BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
11 HISTORY LN, JACKSON, NJ 08527-2209
(732) 367-6600
Mailing address
979 LINDEN AVE, BRICK, NJ 08723-6140
(732) 477-2858
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01165300
NJ
Other
Enumeration date
04/19/2007
Last updated
07/08/2007
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