Pro Form Sports Medicine and Wellness Associates
Pro Form Sports Medicine and Wellness Associates is a Sports Medicine (Emergency Medicine) Physician in Rutherford, New Jersey. Licensed in New Jersey. Registered with an NPI since 2010.
- Licensed in
- NJ
- In the registry since
- 2010
Practice location Address checks out
201 Route 17 11th FlRutherford, NJ 07070-2574
Phone: (201) 549-8846
Fax: (201) 549-8839
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Sports Medicine (Emergency Medicine) Physician (primary) | Taxonomy 207PS0010X · Licence 25MA08835000 (NJ) |
|---|
Record details
| NPI number | 1235432972 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Tae Keun Park — Partner · (646) 489-5640 |
| NPI enumerated | December 20, 2010 |
| Last updated in NPPES | December 20, 2010 |
| Mailing address | 201 Route 17, 11th Floor, Rutherford, NJ 07070-2574 |
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