| Organization Name: | WAYNE PHYSICAL THERAPY & SPINE CENTER |
| NPI Number: | 1255413498 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BARRY INGLETT (CO-OWNER) |
| Mailing Address: | 223 Wanaque Ave Suite 302 Pompton Lakes |
| State: | NJ US |
| Postal Code: | 074422103 |
| Phone Number: | 9738396801 |
| Fax Number: | 9738397293 |
| NPI Enumeration Date: | 10/19/2006 |
| NPI Last Update Date: | 01/29/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |