NPI 1134639479
Tier 1 Fitness
Practice location
- Address
- 5921 Westfield Ave, Pennsauken, NJ 08110-1841
- Phone
- (856) 425-9220
- Mailing address
- 5921 Westfield Avenue, Pennsauken, NJ 08110
Authorised official
- Name
- Antwuan Dyer
- Title
- Member
- Phone
- (856) 425-9220
Registered specialties
Recreation Therapist
Primary
Registry record
- NPI
- 1134639479
- Entity type
- Organization
- NPI issued
- 30 Sep 2017
- Record last updated
- 30 Sep 2017
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.