MEDICARE: JHP PHYSICAL THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1023598174
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JHP PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	135 FORT LEE RD STE 104
Second Line	:
City	:	LEONIA
State	:	NJ
Zip	:	07605-2282
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	135 FORT LEE RD STE 104
Second Line	:
City	:	LEONIA
State	:	NJ
Zip	:	07605-2282
Country	:	US
Telephone Number	:	201-403-1006
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PHYSICAL THERAPIST
Name	:	JINHA PARK
Credential	:	DPT
Telephone Number	:	201-403-1006

Provider Enumeration Date	:	08/17/2018
Last Update Date	:	09/26/2018

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Directions to “JHP PHYSICAL THERAPY LLC ” Practice Location

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