Individual
ERIC IVANCICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
67 LACEY RD, WHITING, NJ 08759-2912
(732) 849-0700
Mailing address
67 LACEY RD, WHITING, NJ 08759-2912
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01423900
NJ
Other
Enumeration date
11/15/2011
Last updated
12/09/2011
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