Provider Demographics
NPI:1992831440
Name:WORK-UP PHYSICAL THERAPY
Entity Type:Organization
Organization Name:WORK-UP PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEMENTS
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:856-546-0377
Mailing Address - Street 1:135 E ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1901
Mailing Address - Country:US
Mailing Address - Phone:856-546-0377
Mailing Address - Fax:856-546-0399
Practice Address - Street 1:WORK-UP PHYSICAL THERAPY
Practice Address - Street 2:135 EAST ATLANTIC AVENUE
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1901
Practice Address - Country:US
Practice Address - Phone:856-546-0377
Practice Address - Fax:856-546-0399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00472300261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ085807Medicare ID - Type UnspecifiedGROUP