Basic Information
Provider Information
NPI: 1487263299
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HORROX
FirstName: ERIC
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1014
Address2:  
City: CLARK
State: NJ
PostalCode: 070661014
CountryCode: US
TelephoneNumber: 7328559751
FaxNumber: 7328559755
Practice Location
Address1: 3121 FIRE RD STE D
Address2:  
City: EGG HARBOR TOWNSHIP
State: NJ
PostalCode: 082349619
CountryCode: US
TelephoneNumber: 6093778881
FaxNumber: 7328559755
Other Information
ProviderEnumerationDate: 07/28/2020
LastUpdateDate: 10/23/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/22/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X40QA01924300NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X40QA01924300PAN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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