Provider Demographics
NPI:1295278372
Name:BEHR, AVERY R (DPT)
Entity type:Individual
Prefix:
First Name:AVERY
Middle Name:R
Last Name:BEHR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:AVERY
Other - Middle Name:
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:237 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST CREEK
Mailing Address - State:NJ
Mailing Address - Zip Code:08092-9733
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:457 JACK MARTIN BLVD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-7776
Practice Address - Country:US
Practice Address - Phone:732-840-7500
Practice Address - Fax:732-840-2088
Is Sole Proprietor?:No
Enumeration Date:2016-11-22
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01945000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist