Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports |
NPI | 1437624269 |
---|---|
Provider Name | Heather Minue |
First Address | Tinton Falls, NJ 07753-7918 |
Second Address | Tinton Falls, NJ 07753-7918 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2018 |
Last Update Date | 08/10/2018 |