Healthcare Provider Details

I. General information

NPI: 1548397847
Provider Name (Legal Business Name): BACK TO HEALTH PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 HOWARD BLVD SUITE J
MT ARLINGTON NJ
07856-2314
US

IV. Provider business mailing address

PO BOX 411
MT ARLINGTON NJ
07856-0411
US

V. Phone/Fax

Practice location:
  • Phone: 973-398-1601
  • Fax:
Mailing address:
  • Phone: 973-398-1601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER BRUSCA
Title or Position: PRESIDENT
Credential: P.T.
Phone: 973-398-1601