| Organization Name: | FAST TRACK PHYSICAL THERAPY, LLC |
| NPI Number: | 1992009203 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KEVIN L LASER (OWNER/PHYSICAL THERAPIST) |
| Mailing Address: | 700 S White Horse Pike Suite D Somerdale |
| State: | NJ US |
| Postal Code: | 080831253 |
| Phone Number: | 8565046930 |
| Fax Number: | 8565046934 |
| NPI Enumeration Date: | 12/29/2010 |
| NPI Last Update Date: | 07/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 40QA01113200 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |