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General NPI Number Information
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NPI Number | 1710450671
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Entity Type | Organization
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Legal Business Name | HANOVER ORTHOPEDIC & SPORTS PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 01/03/2019
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Last Update Date | 01/03/2019
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Provider Practice Location Address
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Address Line | 565 ROUTE 10
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City | WHIPPANY
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State | NJ
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Zip | 07981-1513
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Country | US
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Telephone | 201-572-1012
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Fax |
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Provider Business Mailing Address
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Address Line | 15 BUNKER HILL PL
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City | WHIPPANY
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State | NJ
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Zip | 07981-2216
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Country | US
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Telephone | 201-572-1012
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Fax |
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | KEITH M SCOTT
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Credential | MPT
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Telephone | 201-572-1012
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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 |
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License Number State |
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