Provider Demographics
NPI:1992278907
Name:SPRINGFIELD PHYSICAL THERAPY & WELLNESS
Entity type:Organization
Organization Name:SPRINGFIELD PHYSICAL THERAPY & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:BRITO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:973-467-0011
Mailing Address - Street 1:871 MOUNTAIN AVE
Mailing Address - Street 2:SUITE 122
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081
Mailing Address - Country:US
Mailing Address - Phone:973-467-0011
Mailing Address - Fax:973-467-0111
Practice Address - Street 1:871 MOUNTAIN AVE
Practice Address - Street 2:SUITE 122
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081
Practice Address - Country:US
Practice Address - Phone:973-467-0011
Practice Address - Fax:973-467-0111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1114326816OtherPHYSICAL THERAPY