Provider Demographics
NPI:1265830830
Name:DENVILLE PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:DENVILLE PHYSICAL THERAPY, LLC
Other - Org Name:JOINTCARE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:201-572-3961
Mailing Address - Street 1:3155 RTE 10 E
Mailing Address - Street 2:SUITE 112
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834
Mailing Address - Country:US
Mailing Address - Phone:201-572-3961
Mailing Address - Fax:
Practice Address - Street 1:3155 RTE 10 E
Practice Address - Street 2:SUITE 112
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834
Practice Address - Country:US
Practice Address - Phone:201-572-3961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-15
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty