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General NPI Number Information
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NPI Number | 1023108883
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Entity Type | Organization
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Legal Business Name | TRAINING ROOM LLC
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 12/12/2007
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Provider Practice Location Address
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Address Line | 2005 MARLTON PIKE E
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City | CHERRY HILL
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State | NJ
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Zip | 08003-1279
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Country | US
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Telephone | 856-874-1166
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Fax |
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Provider Business Mailing Address
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Address Line | 2005 MARLTON PIKE E
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City | CHERRY HILL
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State | NJ
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Zip | 08003-1279
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Country | US
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Telephone | 856-874-1166
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. AMANDA J HUGGARD
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Credential | PT
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Telephone | 856-874-1166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA010432
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License Number State | NJ
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