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General NPI Number Information
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NPI Number | 1215351937
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Entity Type | Organization
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Legal Business Name | AMBIENT PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 02/17/2014
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Last Update Date | 02/25/2014
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Provider Practice Location Address
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Address Line | 27 SANDBROOK HEADQUARTERS RD
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City | STOCKTON
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State | NJ
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Zip | 08559-1404
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Country | US
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Telephone | 908-223-5720
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Fax |
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Provider Business Mailing Address
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Address Line | 27 SANDBROOK HEADQUARTERS RD
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City | STOCKTON
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State | NJ
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Zip | 08559-1404
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Country | US
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Telephone | 908-223-5720
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST, PRESIDENT
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Name | MS. DESIREE GIBBS
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Credential | PT,MS
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Telephone | 908-223-5720
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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 | 40QA01187600
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License Number State | NJ
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