Provere Physical Therapy - Montclair, LLC

NPI #1831550078 in Montclair, New Jersey

Provider Information

NPI Number: 1831550078
Entity Type: Organization
Organization Name: Provere Physical Therapy - Montclair, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Mar 16, 2016
Last Updated: Mar 16, 2016

Practice Location

Address: 19 ELM ST
City: Montclair
State: New Jersey
ZIP Code: 07042-3451
Phone: (201) 485-8971

Authorized Official

Name: CEDRIC HADDAD
Title: CEO
Phone: (201) 485-8971

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist - Sports — Sports	2251S0007X
Physical Therapist - Orthopedic — Orthopedic	2251X0800X
Physical Therapist	225100000X	Primary

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