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General NPI Number Information
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NPI Number | 1376601930
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Entity Type | Organization
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Legal Business Name | WEST WINDSOR-PLAINSBORO PHYSICAL THERAPY CENTER, LLC
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 01/21/2009
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Provider Practice Location Address
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Address Line | 666 PLAINSBORO RD SUITE 240
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City | PLAINSBORO
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State | NJ
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Zip | 08536-3004
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Country | US
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Telephone | 690-275-0666
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Fax | 609-275-8004
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Provider Business Mailing Address
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Address Line | 666 PLAINSBORO RD SUITE 240
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City | PLAINSBORO
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State | NJ
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Zip | 08536-3004
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Country | US
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Telephone | 690-275-0666
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Fax | 609-275-8004
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Authorized Official
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Title or Position | CO-OWNER
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Name | MR. BRIAN CHARLES EDGERLY
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Credential | P.T.
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Telephone | 690-275-0666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA00527200
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License Number State | NJ
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