Organization Name: | SYSTEM 4 LIVING WELL |
NPI Number: | 1871854703 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEXTER HOLMES (CEO) |
Mailing Address: | 16 Bristol Rd Piscataway |
State: | NJ US |
Postal Code: | 088543610 |
Phone Number: | 7326407107 |
Fax Number: | 8664219357 |
NPI Enumeration Date: | 06/07/2012 |
NPI Last Update Date: | 07/05/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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 |