92 Brick Road Operating Company LLC
Clinical Neuropsychologist in Marlton, NJ. Organization (NPI-2).
NPI number1528258191
StatusActive
Last updated in NPPESAug 8, 2013
Details
- NPI
- 1528258191
- Entity type
- Organization (NPI-2)
- Legal business name
- 92 Brick Road Operating Company LLC
- Organization subpart
- No
- Enumeration date
- Jul 30, 2007
- Last updated
- Aug 8, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | – | – | Yes |
| 208100000X | Physical Medicine & Rehabilitation | – | – |
Other names
- Marlton Rehabilitation Hospital (Doing Business As)
Practice location
92 Brick RdMarlton, NJ 08053-2177
Phone 856-988-8778 · Fax 856-988-8254
Mailing address
92 Brick RdMarlton, NJ 08053-2177
Phone 856-988-4100 · Fax 609-261-7199
Authorized official
Brad E. Hollinger
President
7175915700
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