Healthcare Provider Details

I. General information

NPI: 1114631421
Provider Name (Legal Business Name): PELVIC RESET PHYSICAL THERAPY & WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2023
Last Update Date: 02/17/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 WILLOWBROOK DR
NORTH BRUNSWICK NJ
08902-1255
US

IV. Provider business mailing address

232 WILLOWBROOK DR
NORTH BRUNSWICK NJ
08902-1255
US

V. Phone/Fax

Practice location:
  • Phone: 732-322-0023
  • Fax:
Mailing address:
  • Phone: 732-322-0023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. TULSI S SHAH
Title or Position: OWNER (MANAGING MEMBER)
Credential: PHYSICAL THERAPIST
Phone: 732-322-0023