Basic Information
| Provider Information | |||||||||
| NPI: | 1528248366 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FOX AMBULATORY PHYSICAL THERAPY LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 N KINGS HWY | ||||||||
| Address2: | |||||||||
| City: | CHERRY HILL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080341513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8774073422 | ||||||||
| FaxNumber: | 8774074329 | ||||||||
| Practice Location | |||||||||
| Address1: | 611 NEW RD | ||||||||
| Address2: | |||||||||
| City: | NORTHFIELD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082251669 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6093830283 | ||||||||
| FaxNumber: | 6093832330 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2007 | ||||||||
| LastUpdateDate: | 11/09/2007 | ||||||||
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| AuthorizedOfficialLastName: | FOX | ||||||||
| AuthorizedOfficialFirstName: | TIMOTHY | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8774073422 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MSPT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QX0100X | N | Ambulatory Health Care Facilities | Clinic/Center | Occupational Medicine | 261QP2000X | NJ | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.