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General NPI Number Information
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NPI Number | 1639646722
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY AND WELLNESS AT SOMERSET
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Dates
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Enumeration Date | 10/27/2018
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Last Update Date | 10/27/2018
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Provider Practice Location Address
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Address Line | 13 CLYDE RD STE 101
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City | SOMERSET
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State | NJ
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Zip | 08873-5037
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Country | US
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Telephone | 173-264-9391
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Fax |
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Provider Business Mailing Address
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Address Line | 13 CLYDE RD STE 101
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City | SOMERSET
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State | NJ
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Zip | 08873-5037
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Country | US
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Telephone | 173-264-9391
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MOHAMMED H RAZA
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Credential | DPT
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Telephone | 732-991-2542
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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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