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General NPI Number Information
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NPI Number | 1558165902
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Entity Type | Organization
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Legal Business Name | BACK TO BARBELL SPORTS REHABILITATION AND PERFORMANCE LLC
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 224 STOCKTON ST
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City | PHILLIPSBURG
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State | NJ
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Zip | 08865-2948
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Country | US
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Telephone | 201-455-7417
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Fax | 833-936-1249
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Provider Business Mailing Address
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Address Line | 384 SPRING GARDEN RD
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City | MILFORD
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State | NJ
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Zip | 08848-1817
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEVIN CREVANI
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Credential | DPT
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Telephone | 201-455-7417
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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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