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General NPI Number Information
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NPI Number | 1386313807
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Entity Type | Organization
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Legal Business Name | VG PHYSICAL THERAPY
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Dates
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Enumeration Date | 09/08/2021
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 230 MIDLAND AVENUE
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City | SADDLE BROOK
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State | NJ
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Zip | 07663-0766
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Country | US
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Telephone | 973-478-2212
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Fax | 973-478-2123
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Provider Business Mailing Address
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Address Line | 55 CHELSEA AVE APT 409
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City | LONG BRANCH
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State | NJ
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Zip | 07740-8166
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Country | US
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Telephone | 973-478-2212
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Fax | 973-478-2123
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | VALERIE GREOGRY
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Credential | PT
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Telephone | 973-478-2212
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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 |
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License Number State |
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