Provider Demographics
NPI:1699050211
Name:PREMIER PHYSICAL THERAPY AT CAN DO
Entity type:Organization
Organization Name:PREMIER PHYSICAL THERAPY AT CAN DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:973-467-4444
Mailing Address - Street 1:PO BOX 510
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-0510
Mailing Address - Country:US
Mailing Address - Phone:973-467-4444
Mailing Address - Fax:973-467-4446
Practice Address - Street 1:750 MORRIS TPKE
Practice Address - Street 2:
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078-2614
Practice Address - Country:US
Practice Address - Phone:973-467-4444
Practice Address - Fax:973-467-4446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty