Provider Demographics
NPI:1407068687
Name:HAMMONTON ORTHOPEDIC AND SPORTS PHYSICAL THERAPY
Entity Type:Organization
Organization Name:HAMMONTON ORTHOPEDIC AND SPORTS PHYSICAL THERAPY
Other - Org Name:ATLANTIC ORTHOPEDIC AND SPORTS PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:CALABRIA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:609-704-1980
Mailing Address - Street 1:289 WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:ATCO
Mailing Address - State:NJ
Mailing Address - Zip Code:08004-2257
Mailing Address - Country:US
Mailing Address - Phone:856-753-5523
Mailing Address - Fax:609-704-9054
Practice Address - Street 1:289 WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:ATCO
Practice Address - State:NJ
Practice Address - Zip Code:08004-2257
Practice Address - Country:US
Practice Address - Phone:856-753-5523
Practice Address - Fax:609-704-9054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy