Provider Demographics
NPI:1043385941
Name:WEES PHYSICAL THERAPY AND WELLNESS CLINIC
Entity Type:Organization
Organization Name:WEES PHYSICAL THERAPY AND WELLNESS CLINIC
Other - Org Name:WEES HEALTH CARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUNG BAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WEE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:201-886-1200
Mailing Address - Street 1:1055 PALISADE AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-6329
Mailing Address - Country:US
Mailing Address - Phone:201-886-1200
Mailing Address - Fax:201-886-0119
Practice Address - Street 1:1055 PALISADE AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-6329
Practice Address - Country:US
Practice Address - Phone:201-886-1200
Practice Address - Fax:201-886-0119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01192500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty