Provider Demographics
NPI:1033684758
Name:PTMAX PHYSICAL THERAPY AND WELLNESS
Entity Type:Organization
Organization Name:PTMAX PHYSICAL THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERUM
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:215-278-2229
Mailing Address - Street 1:227 HADLEIGH DR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1936
Mailing Address - Country:US
Mailing Address - Phone:215-531-4353
Mailing Address - Fax:
Practice Address - Street 1:1051 W SHERMAN AVE STE 1B
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-6931
Practice Address - Country:US
Practice Address - Phone:215-278-2229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty