Individual
MR. CRAIG MICHAEL WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1945 ROUTE 33, NEPTUNE, NJ 07753-4859
(732) 775-5500
Mailing address
1606 MAIN ST, UNIT F-302, LAKE COMO, NJ 07719-3085
(732) 556-6609
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01249800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40QA01249800
BOARD OF PHYSICAL THERAPY
NJ
Enumeration date
08/08/2007
Last updated
10/09/2011
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