Provider Demographics
NPI:1639371875
Name:HIGHWAY TO FITNESS
Entity Type:Organization
Organization Name:HIGHWAY TO FITNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:L
Authorized Official - Last Name:BILLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-440-0497
Mailing Address - Street 1:14 PARKE PLACE BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2661
Mailing Address - Country:US
Mailing Address - Phone:609-440-0497
Mailing Address - Fax:856-256-8390
Practice Address - Street 1:14 PARKE PLACE BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2661
Practice Address - Country:US
Practice Address - Phone:609-440-0497
Practice Address - Fax:856-256-8390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00489700261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ063438Medicare ID - Type Unspecified