| Organization Name: | 176 RT 9 NORTH |
| NPI Number: | 1831513332 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JASON LAMENDOLA (OWNER) |
| Mailing Address: | 176 Rte 9 Ste# 204 Englishtown |
| State: | NJ US |
| Postal Code: | 077269218 |
| Phone Number: | 7188166500 |
| Fax Number: | 7188164677 |
| NPI Enumeration Date: | 02/05/2014 |
| NPI Last Update Date: | 02/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 40QA01318300 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |