Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 40QA01027600 | NJ |
N | 2251S0007X | Physical Therapist - Sports | 40QA01027600 | NJ |
N | 2251X0800X | Physical Therapist - Orthopedic | 40QA01027600 | NJ |
NPI | 1154355774 |
---|---|
Provider Name | Mr. John William Fleischman |
First Address | Sewell, NJ 08080-9229 |
Second Address | Sewell, NJ 08080-9229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 07/12/2010 |