Provider Demographics
NPI:1720601685
Name:WOODBRIDGE PHYSICAL THERAPY AND REHAB LLC
Entity Type:Organization
Organization Name:WOODBRIDGE PHYSICAL THERAPY AND REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-254-2273
Mailing Address - Street 1:3 AUER CT STE D
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5825
Mailing Address - Country:US
Mailing Address - Phone:732-254-2273
Mailing Address - Fax:732-254-1533
Practice Address - Street 1:523 GREEN ST
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-2618
Practice Address - Country:US
Practice Address - Phone:732-254-2273
Practice Address - Fax:732-254-1533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty