Healthcare Provider Details

I. General information

NPI: 1215588090
Provider Name (Legal Business Name): TOTAL HEALTH PHYSICAL MEDICINE AND REHAB CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2019
Last Update Date: 11/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 MAIN RD STE 100
MONTVILLE NJ
07045-9231
US

IV. Provider business mailing address

137 MAIN RD STE 100
MONTVILLE NJ
07045-9231
US

V. Phone/Fax

Practice location:
  • Phone: 973-947-6700
  • Fax:
Mailing address:
  • Phone: 973-947-6700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: JANICE HARMS
Title or Position: MANAGER
Credential:
Phone: 973-377-6327