Orthopedic & Spine Rehabilitation, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

40QA00312500 Issued in NJ

Legal business name

ORTHOPEDIC & SPINE REHABILITATION, LLC

Practice address

73 N Maple Ave
Suite a
Marlton, NJ 08053-1782

Phone

(856) 797-6778

Fax

(856) 797-8011

NPI assigned

Nov 17, 2007

Last updated

Nov 17, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gary Samuel Harris, PT, OCSNPI 1326119652

Title

Owner

Phone

(856) 797-6778

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gary Samuel Harris, PT, OCS

  • Physical Therapist
  • Marlton, NJ
  • NPI 1326119652
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195257600000",
    "number": "1093996175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 N MAPLE AVE",
            "address_2": "SUITE A",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531782",
            "telephone_number": "856-797-6778",
            "fax_number": "856-797-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 N MAPLE AVE",
            "address_2": "SUITE A",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531782",
            "telephone_number": "856-797-6778",
            "fax_number": "856-797-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC & SPINE REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-17",
        "last_updated": "2007-11-17",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-797-6778",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT, OCS"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NJ",
            "license": "40QA00312500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.