Organization
INNOVATIVE THERAPY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM SICKER (OWNER)
(723) 415-8990
Entity
Organization
Contact information
Practice address
746 PARK AVE, LAKEWOOD, NJ 08701-2025
(732) 415-8990
Mailing address
746 PARK AVE, LAKEWOOD, NJ 08701-2025
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
12/12/2013
Last updated
12/12/2013
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