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General NPI Number Information
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NPI Number | 1639681109
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Entity Type | Organization
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Legal Business Name | RESILIENT PERFORMANCE PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 10/24/2017
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Last Update Date | 10/24/2017
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Provider Practice Location Address
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Address Line | 100 PASSAIC AVE
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City | CHATHAM
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State | NJ
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Zip | 07928-2848
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Country | US
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Telephone | 800-567-1891
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Fax |
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Provider Business Mailing Address
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Address Line | 3900 GREYSTONE AVE APT 61C
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City | BRONX
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State | NY
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Zip | 10463-1928
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Country | US
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Telephone | 309-824-5130
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. TREVOR RAPPA
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Credential |
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Telephone | 309-824-5130
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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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