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General NPI Number Information
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NPI Number | 1780167544
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Entity Type | Organization
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Legal Business Name | MAG PHYSICAL THERAPY, PILATES & WELLNESS
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Dates
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Enumeration Date | 09/07/2018
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Last Update Date | 06/23/2022
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Provider Practice Location Address
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Address Line | 84 ELM ST STE B
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City | WESTFIELD
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State | NJ
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Zip | 07090-2181
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Country | US
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Telephone | 908-543-4936
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Fax |
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Provider Business Mailing Address
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Address Line | 84 ELM ST STE B
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City | WESTFIELD
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State | NJ
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Zip | 07090-2181
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Country | US
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Telephone | 908-543-4936
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Fax |
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Authorized Official
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Title or Position | FOUNDER AND CEO
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Name | MELISSA JEANS MAGLAQUE
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Credential | PT, DPT, OCS
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Telephone | 908-543-4936
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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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