Provider Demographics
NPI:1730760240
Name:SHORE STRENGTH PHYSICAL THERAPY AND SPORTS PERFORMANCE
Entity type:Organization
Organization Name:SHORE STRENGTH PHYSICAL THERAPY AND SPORTS PERFORMANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EZRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEMOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-251-7358
Mailing Address - Street 1:13 EISELE AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-4128
Mailing Address - Country:US
Mailing Address - Phone:908-251-7358
Mailing Address - Fax:
Practice Address - Street 1:13 EISELE AVE
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-4128
Practice Address - Country:US
Practice Address - Phone:908-251-7358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy