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General NPI Number Information
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NPI Number | 1932694148
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Entity Type | Organization
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Legal Business Name | PLAINSBORO PHYSICAL THERAPY AND WELLNESS LLC
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Dates
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Enumeration Date | 06/29/2018
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Last Update Date | 06/29/2018
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Provider Practice Location Address
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Address Line | 21 LINWOOD DR
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City | MONROE TOWNSHIP
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State | NJ
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Zip | 08831-3788
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Country | US
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Telephone | 732-731-9652
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 606
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City | PLAINSBORO
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State | NJ
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Zip | 08536-0606
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Country | US
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Telephone | 732-731-9652
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MELODY SANTOS
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Credential | PT
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Telephone | 732-731-9652
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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 | PT40QA00712500
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License Number State | NJ
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