Healthcare Provider Details

I. General information

NPI: 1023796141
Provider Name (Legal Business Name): J AND L PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 07/10/2023
Certification Date: 07/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CRAIG RD
SPRINGFIELD NJ
07081-2709
US

IV. Provider business mailing address

10 CRAIG RD
SPRINGFIELD NJ
07081-2709
US

V. Phone/Fax

Practice location:
  • Phone: 973-714-8600
  • Fax:
Mailing address:
  • Phone: 973-714-8600
  • 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 Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DANIEL WONG
Title or Position: OWNER /MANAGER
Credential: D.P.T
Phone: 973-714-8600