Organization Name: | GLOUCESTER PHYSICAL THERAPY, PC |
NPI Number: | 1295837722 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MAIKUTLO B KEBAETSE (PRESIDENT) |
Mailing Address: | 541 Mantua Ave Paulsboro |
State: | NJ US |
Postal Code: | 080661178 |
Phone Number: | 8562240400 |
Fax Number: | 8562240466 |
NPI Enumeration Date: | 09/04/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 40QA00685900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |