Provider Demographics
NPI:1790515674
Name:MARLTON THERAPY GROUP
Entity type:Organization
Organization Name:MARLTON THERAPY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDSTETTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-265-0558
Mailing Address - Street 1:1000 LINCOLN DR E STE 2B
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-1566
Mailing Address - Country:US
Mailing Address - Phone:856-265-0558
Mailing Address - Fax:856-265-0558
Practice Address - Street 1:1000 LINCOLN DR E STE 2B
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-1566
Practice Address - Country:US
Practice Address - Phone:856-265-0558
Practice Address - Fax:856-265-0558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-05
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)