Provider Demographics
NPI:1730369992
Name:THE S.M.A.R.T. CENTER
Entity type:Organization
Organization Name:THE S.M.A.R.T. CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:SCHULER
Authorized Official - Last Name:MOSS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:856-234-9100
Mailing Address - Street 1:300 CHESTER AVE
Mailing Address - Street 2:SUITE 204A
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-2512
Mailing Address - Country:US
Mailing Address - Phone:856-234-9100
Mailing Address - Fax:856-234-9103
Practice Address - Street 1:300 CHESTER AVE
Practice Address - Street 2:SUITE 204A
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-2512
Practice Address - Country:US
Practice Address - Phone:856-234-9100
Practice Address - Fax:856-234-9103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00500500261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation