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General NPI Number Information
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NPI Number | 1326291105
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Entity Type | Organization
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Legal Business Name | ENVISION REHABILITATION
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Dates
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Enumeration Date | 10/24/2008
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Last Update Date | 10/24/2008
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Provider Practice Location Address
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Address Line | 860 ROUTE 168 SUITE 106
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City | TURNERSVILLE
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State | NJ
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Zip | 08012-3215
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Country | US
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Telephone | 856-340-3301
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Fax |
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Provider Business Mailing Address
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Address Line | 1625 CHARTER OAK AVE
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City | BLACKWOOD
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State | NJ
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Zip | 08012-5007
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Country | US
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Telephone | 856-340-3301
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | BRIAN PIMPINELLO
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Credential |
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Telephone | 856-340-3301
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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 | 40QA00854100
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License Number State | NJ
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