Provider Demographics
NPI:1982188926
Name:TORO PHYSICAL THERAPY AND PERFORMANCE TRAINING LLC
Entity Type:Organization
Organization Name:TORO PHYSICAL THERAPY AND PERFORMANCE TRAINING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CARMEN
Authorized Official - Last Name:IANNELLI
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPT, PT
Authorized Official - Phone:856-237-7467
Mailing Address - Street 1:1165 N TUCKAHOE RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08094-3459
Mailing Address - Country:US
Mailing Address - Phone:856-237-7467
Mailing Address - Fax:856-716-6525
Practice Address - Street 1:1165 N TUCKAHOE RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08094-3459
Practice Address - Country:US
Practice Address - Phone:856-237-7467
Practice Address - Fax:856-716-6525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-15
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy