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General NPI Number Information
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NPI Number | 1568840080
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Entity Type | Organization
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Legal Business Name | MAYWOOD PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 05/16/2015
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Last Update Date | 09/15/2022
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Provider Practice Location Address
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Address Line | 119 E PASSAIC ST
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City | MAYWOOD
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State | NJ
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Zip | 07607-1342
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Country | US
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Telephone | 201-880-7787
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Fax |
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Provider Business Mailing Address
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Address Line | 119 E PASSAIC ST
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City | MAYWOOD
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State | NJ
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Zip | 07607-1342
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Country | US
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Telephone | 201-880-7787
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. DANIEL HANNA
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Credential | DC
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Telephone | 201-880-7787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38MC00710100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38MC00722200
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 40QA01639000
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License Number State | NJ
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