Most Relevant Information
Provider Data
| NPI Number: | 1003031709 |
| Provider Name: | BARTOLOME AMOS TAN PT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 40QA00729300 |
Most Important Dates
| Enumeration Date: | 04/16/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
62 GRIECO DR
JERSEY CITY
NJ
073054898
Practice Location Phone/Fax
| Phone: | 2014513733 |
| Fax: | 2014513733 |
Provider Mailing Location
62 GRIECO DR
JERSEY CITY
NJ
073054898
Provider Mailing Phone/Fax
| Phone: | 2014513733 |
| Fax: | 2014513733 |