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General NPI Number Information
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NPI Number | 1396552907
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Entity Type | Organization
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Legal Business Name | ENHANCE PERFORMANCE PHYSICAL THERAPY
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Dates
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Enumeration Date | 12/17/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 3407 ROSE AVE
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City | OCEAN
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State | NJ
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Zip | 07712-3968
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Country | US
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Telephone | 732-570-5037
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Fax |
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Provider Business Mailing Address
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Address Line | 515 WOODMERE AVE
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City | NEPTUNE
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State | NJ
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Zip | 07753-5635
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Country | US
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Telephone | 732-570-5037
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Fax |
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Authorized Official
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Title or Position | OWNER/LEAD PHYSICAL THERAPIST
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Name | KELLY GUTKES
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Credential | DPT
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Telephone | 732-570-5037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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