Provider Demographics
NPI:1386505378
Name:MOUNT LAUREL PHYSICAL THERAPY
Entity type:Organization
Organization Name:MOUNT LAUREL PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWER
Authorized Official - Prefix:
Authorized Official - First Name:KENAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NUHODZIC
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:607-342-1294
Mailing Address - Street 1:55 BOLZ CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-3377
Mailing Address - Country:US
Mailing Address - Phone:607-342-1294
Mailing Address - Fax:
Practice Address - Street 1:55 BOLZ CT
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-3377
Practice Address - Country:US
Practice Address - Phone:607-342-1294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-19
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy