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General NPI Number Information
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NPI Number | 1306996293
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Entity Type | Organization
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Legal Business Name | JERSEY SHORE PHYSICAL THERAPY AND REHAB
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 1423 TILTON RD SUITE 10
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City | NORTHFIELD
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State | NJ
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Zip | 08225-1857
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Country | US
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Telephone | 609-677-8778
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Fax | 609-677-9229
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Provider Business Mailing Address
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Address Line | 1423 TILTON RD SUITE 10
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City | NORTHFIELD
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State | NJ
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Zip | 08225-1857
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Country | US
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Telephone | 609-677-8778
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Fax | 609-677-9229
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Authorized Official
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Title or Position | OWNER PHYSICAL THERAPIST
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Name | ANTHONY JOHN VISGIL JR.
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Credential | P.T.
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Telephone | 609-677-8778
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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 | 40QA00131700
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License Number State | NJ
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