| Organization Name: | PRESTIGE PHYSICAL THERAPY, L.L.C. |
| NPI Number: | 1003932880 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KEITH ALLEN ROGERS (OWNER) |
| Mailing Address: | 463 Livingston St Suite 203 Norwood |
| State: | NJ US |
| Postal Code: | 076481344 |
| Phone Number: | 2019217766 |
| Fax Number: | |
| NPI Enumeration Date: | 03/22/2007 |
| NPI Last Update Date: | 01/31/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 40QA00966100 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |