Provider Demographics
NPI:1467697086
Name:INTEGRITY REHABILITATION AMBULATORY THERAPY AND WELLNESS SERVICES LLC
Entity Type:Organization
Organization Name:INTEGRITY REHABILITATION AMBULATORY THERAPY AND WELLNESS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RUDOLPH
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:CHRISTOPHER
Authorized Official - Suffix:III
Authorized Official - Credentials:MPT
Authorized Official - Phone:609-442-1212
Mailing Address - Street 1:115 IRIS DR
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-6105
Mailing Address - Country:US
Mailing Address - Phone:609-442-1212
Mailing Address - Fax:609-645-3439
Practice Address - Street 1:331 TILTON RD
Practice Address - Street 2:SUITE 7
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1201
Practice Address - Country:US
Practice Address - Phone:609-241-6339
Practice Address - Fax:609-241-6348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-10
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00810700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty