Organization Name: | MAXIMUM PERFORMANCE PHYSICAL THERAPY AND SPORTS REHABILITATION |
NPI Number: | 1043566367 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES VAN DIEN (PHYSICAL THERAPIST) |
Mailing Address: | 170 Schuyler Ave North Arlington |
State: | NJ US |
Postal Code: | 070315412 |
Phone Number: | 2019913800 |
Fax Number: | |
NPI Enumeration Date: | 07/24/2012 |
NPI Last Update Date: | 12/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 40QA01259400 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |