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General NPI Number Information
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NPI Number | 1861184079
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Entity Type | Organization
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Legal Business Name | REBALANCE PHYSICAL THERAPY AND WELLNESS LLC
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Dates
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Enumeration Date | 05/24/2023
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 191 RAMAPO VALLEY RD
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City | OAKLAND
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State | NJ
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Zip | 07436-2538
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Country | US
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Telephone | 201-749-5404
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8302
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City | NORTH BERGEN
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State | NJ
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Zip | 07047-8302
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUNNY THAKKAR
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Credential |
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Telephone | 201-749-5404
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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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