Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 40QA01964600 | NJ |
N | 2251G0304X | Physical Therapist - Geriatrics | 40QA01964600 | NJ |
NPI | 1275108102 |
---|---|
Provider Name | Christine L Osborn |
First Address | Clark, NJ 07066-1014 |
Second Address | Egg Harbor Township, NJ 08234-9619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2021 |
Last Update Date | 27/08/2021 |