Healthcare Provider Details

I. General information

NPI: 1528248366
Provider Name (Legal Business Name): FOX AMBULATORY PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2007
Last Update Date: 11/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 NEW RD
NORTHFIELD NJ
08225-1669
US

IV. Provider business mailing address

801 N KINGS HWY
CHERRY HILL NJ
08034-1513
US

V. Phone/Fax

Practice location:
  • Phone: 609-383-0283
  • Fax: 609-383-2330
Mailing address:
  • Phone: 877-407-3422
  • Fax: 877-407-4329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. TIMOTHY A FOX
Title or Position: OWNER
Credential: MSPT
Phone: 877-407-3422