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General NPI Number Information
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NPI Number | 1306372719
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Entity Type | Organization
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Legal Business Name | ADAPT PERFORMANCE AND REHAB
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Dates
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Enumeration Date | 05/04/2017
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Last Update Date | 09/28/2021
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Provider Practice Location Address
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Address Line | 8 LACKAWANNA PLZ STE A
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City | MONTCLAIR
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State | NJ
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Zip | 07042-3604
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Country | US
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Telephone | 973-319-4015
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Fax |
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Provider Business Mailing Address
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Address Line | 8 LACKAWANNA PLZ STE A
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City | MONTCLAIR
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State | NJ
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Zip | 07042-3604
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Country | US
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Telephone | 973-319-4015
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER, PHYSICAL THERAPIST
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Name | DR. ADAPT PHYSICAL THERAPY
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Credential | PT, DPT, CAFS, CIDN
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Telephone | 973-319-4015
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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 | 40QA01640300
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License Number State | NJ
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