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General NPI Number Information
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NPI Number | 1790287472
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Entity Type | Organization
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Legal Business Name | PARAGON SPORTS REHAB, LLC
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Dates
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Enumeration Date | 03/08/2018
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Last Update Date | 03/08/2018
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Provider Practice Location Address
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Address Line | 127 ROUTE 206
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City | HAMILTON
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State | NJ
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Zip | 08610-4300
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Country | US
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Telephone | 609-807-1760
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Fax |
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Provider Business Mailing Address
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Address Line | 1 N COMMERCE SQ STE 102
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City | ROBBINSVILLE
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State | NJ
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Zip | 08691-0003
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Country | US
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Telephone | 914-443-8150
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | DR. JAMES M THOLANY
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Credential | PT, DPT
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Telephone | 914-443-8150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 40QA01359200
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License Number State | NJ
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