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General NPI Number Information
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NPI Number | 1154625721
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Entity Type | Organization
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Legal Business Name | WOODSTOWN PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 12/22/2010
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Last Update Date | 03/10/2022
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Provider Practice Location Address
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Address Line | 84 E GRANT ST
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City | WOODSTOWN
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State | NJ
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Zip | 08098-1400
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Country | US
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Telephone | 856-769-4564
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Fax | 856-769-4637
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Provider Business Mailing Address
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Address Line | 84 E GRANT ST SUITE 3
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City | WOODSTOWN
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State | NJ
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Zip | 08098-1400
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Country | US
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Telephone | 856-769-4564
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Fax | 856-769-4637
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK L VALENTE
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Credential |
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Telephone | 856-769-4564
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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 |
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License Number State |
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