=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275003162
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SPORTS AND WELLNESS PHYSICAL THERAPIES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/04/2018
-----------------------------------------------------
Last Update Date | 08/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 HEATHER DR
-----------------------------------------------------
City | EAST HANOVER
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07936-3203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-202-7225
-----------------------------------------------------
Fax | 973-585-6162
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 HEATHER DR
-----------------------------------------------------
City | EAST HANOVER
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07936-3203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-202-7225
-----------------------------------------------------
Fax | 973-585-6162
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | NANCY RITSCHEL
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 973-202-7225
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------