Provider Demographics
NPI:1508324864
Name:PRECISION SPORTS PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:PRECISION SPORTS PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KULIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:609-457-0555
Mailing Address - Street 1:1395 ROUTE 539 STE 2
Mailing Address - Street 2:
Mailing Address - City:LITTLE EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-9770
Mailing Address - Country:US
Mailing Address - Phone:609-978-0242
Mailing Address - Fax:609-879-5484
Practice Address - Street 1:50 WILLIAMS PKWY STE D
Practice Address - Street 2:
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936-2110
Practice Address - Country:US
Practice Address - Phone:973-585-6008
Practice Address - Fax:609-879-5484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-06
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty