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General NPI Number Information
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NPI Number | 1477619146
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Entity Type | Individual
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Provider Name | ROBERT HARDING WITT PT
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Gender | Male
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 104 STOCKTON AVENUE
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City | OCEAN GROVE
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State | NJ
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Zip | 07756-1049
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Country | US
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Telephone | 732-776-9024
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Fax | 732-776-9024
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Provider Business Mailing Address
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Address Line | 104 STOCKTON AVENUE
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City | OCEAN GROVE
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State | NJ
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Zip | 07756-1049
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Country | US
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Telephone | 732-776-9024
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Fax | 732-776-9024
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 40QA00167800
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License Number State | NJ
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