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General NPI Number Information
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NPI Number | 1487161931
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Entity Type | Organization
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Legal Business Name | PRO POPLAR INC.
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Dates
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Enumeration Date | 01/05/2018
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Last Update Date | 01/05/2018
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Provider Practice Location Address
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Address Line | 736 CLARENCE ST STE 205
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City | WESTFIELD
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State | NJ
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Zip | 07090-4449
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Country | US
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Telephone | 908-548-3578
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Fax |
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Provider Business Mailing Address
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Address Line | 736 CLARENCE ST STE 205
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City | WESTFIELD
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State | NJ
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Zip | 07090-4449
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Country | US
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Telephone | 908-548-3578
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL
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Name | MR. ZHONG LU
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Credential |
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Telephone | 908-548-3578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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