Pro Form Sports Medicine and Wellness Associates
Pro Form Sports Medicine and Wellness Associates provides Sports Medicine (Emergency Medicine) Physician services 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 Not confirmed with CMS for 15 years — call before visiting
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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