Organization Name: | POLARIS PHYSICAL THERAPY,P.C. |
NPI Number: | 1073678751 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERTO YANEZ (PHYSICAL THERAPY DIRECTOR) |
Mailing Address: | 284 Delsea Dr Sewell |
State: | NJ US |
Postal Code: | 080809469 |
Phone Number: | 8565341052 |
Fax Number: | 8568810077 |
NPI Enumeration Date: | 12/24/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251X0800X |
License Number: | 40QA00393000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Orthopedic |
Taxonomy Definition: |