Healthcare Provider Details

I. General information

NPI: 1659593697
Provider Name (Legal Business Name): THERAPY AND LIVING CONSULTANTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 01/09/2023
Certification Date: 01/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 N CORNWALL AVE STE 3
VENTNOR CITY NJ
08406-1357
US

IV. Provider business mailing address

509 N CORNWALL AVE STE 3
VENTNOR CITY NJ
08406-1357
US

V. Phone/Fax

Practice location:
  • Phone: 609-513-0979
  • Fax: 609-645-8182
Mailing address:
  • Phone: 609-513-0979
  • 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: PATRICIA BRICK
Title or Position: OWNER
Credential: PT
Phone: 609-513-0979