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General NPI Number Information
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NPI Number | 1104160555
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Entity Type | Organization
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Legal Business Name | TOTAL CARE PHYSICAL THERAPY, P.C.
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Dates
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Enumeration Date | 11/23/2012
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Last Update Date | 11/23/2012
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Provider Practice Location Address
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Address Line | 719 ROUTE 206
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City | HILLSBOROUGH
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State | NJ
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Zip | 08844-1536
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Country | US
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Telephone | 908-229-2878
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Fax |
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Provider Business Mailing Address
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Address Line | 719 ROUTE 206
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City | HILLSBOROUGH
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State | NJ
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Zip | 08844-1536
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Country | US
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Telephone | 908-229-2878
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANASTASIOS BOUZIOTIS
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Credential | MSPT
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Telephone | 908-229-2878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01120600
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License Number State | NJ
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