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General NPI Number Information
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NPI Number | 1588052955
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Entity Type | Organization
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Legal Business Name | TRUBODY PHYSICAL THERAPY
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Dates
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Enumeration Date | 01/07/2015
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Last Update Date | 01/07/2015
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Provider Practice Location Address
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Address Line | 1911 CINNAMINSON AVE
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City | CINNAMINSON
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State | NJ
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Zip | 08077-2818
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Country | US
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Telephone | 855-698-7826
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Fax |
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Provider Business Mailing Address
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Address Line | 9303 BLUE HERON CT
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City | PALMYRA
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State | NJ
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Zip | 08065-2162
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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 | DR. TONIESHA NYKIMA UTUK
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Credential | DPT
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Telephone | 609-505-1774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01440200
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License Number State | NJ
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