Provider Demographics
NPI:1083409692
Name:PRIME SPORTS PHYSICAL THERAPY AND CHIROPRACTIC LLC
Entity type:Organization
Organization Name:PRIME SPORTS PHYSICAL THERAPY AND CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:C
Authorized Official - Last Name:BREMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-783-2332
Mailing Address - Street 1:80 E RTE 4 STE 100
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2647
Mailing Address - Country:US
Mailing Address - Phone:201-905-1011
Mailing Address - Fax:551-295-7552
Practice Address - Street 1:80 E RTE 4 STE 100
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2647
Practice Address - Country:US
Practice Address - Phone:201-905-1011
Practice Address - Fax:551-295-7552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty