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General NPI Number Information
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NPI Number | 1932262532
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Entity Type | Organization
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Legal Business Name | J DE HEER LLC
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 125 BURNT MILL RD
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City | CHERRY HILL
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State | NJ
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Zip | 08003-3903
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Country | US
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Telephone | 856-354-8040
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Fax | 856-354-8042
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Provider Business Mailing Address
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Address Line | 125 BURNT MILL RD
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City | CHERRY HILL
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State | NJ
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Zip | 08003-3903
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Country | US
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Telephone | 856-354-8040
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Fax | 856-354-8042
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | JANE DE HEER
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Credential | DPT
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Telephone | 856-354-8040
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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 | 40QA00632400
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License Number State | NJ
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