Provider Demographics
NPI:1578691275
Name:MICHELE VANDELL, P.T. DBA PREFERRED CARE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:MICHELE VANDELL, P.T. DBA PREFERRED CARE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDELL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:732-706-0776
Mailing Address - Street 1:590 HWY 35 AND APPLE FARM RD.
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5048
Mailing Address - Country:US
Mailing Address - Phone:732-706-0776
Mailing Address - Fax:732-706-7797
Practice Address - Street 1:590 HWY 35 AND APPLE FARM RD.
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5048
Practice Address - Country:US
Practice Address - Phone:732-706-0776
Practice Address - Fax:732-706-7797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00519300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty