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General NPI Number Information
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NPI Number | 1740853688
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Entity Type | Organization
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Legal Business Name | PELVIC FLOOR & CORE THERAPY
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Dates
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Enumeration Date | 07/19/2021
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Last Update Date | 07/19/2021
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Provider Practice Location Address
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Address Line | 10 TAFT AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5664
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Country | US
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Telephone | 732-267-7054
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Fax |
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Provider Business Mailing Address
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Address Line | 10 TAFT AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5664
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Country | US
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Telephone | 732-267-7054
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPY
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Name | ROSALYN ITZKOWITZ
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Credential | MS OTR/L
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Telephone | 732-267-7054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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