Provider Demographics
NPI:1568873248
Name:TRAINING ROOM OF HADDONFIELD, LLC
Entity Type:Organization
Organization Name:TRAINING ROOM OF HADDONFIELD, LLC
Other - Org Name:THE TRAINING ROOM OF HADDONFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HUGGARD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:856-616-8001
Mailing Address - Street 1:320 N HADDON AVE
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-1756
Mailing Address - Country:US
Mailing Address - Phone:856-616-8000
Mailing Address - Fax:856-616-8001
Practice Address - Street 1:320 N HADDON AVE
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-1756
Practice Address - Country:US
Practice Address - Phone:856-616-8000
Practice Address - Fax:856-616-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-15
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPT40QA01043200261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy