Basic Information
| Provider Information | |||||||||
| NPI: | 1649727181 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | THEINERT | ||||||||
| FirstName: | ZACHARY | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 40 HALF ACRE RD | ||||||||
| Address2: | |||||||||
| City: | JAMESBURG | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088311148 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 PRINCETON HIGHTSTOWN RD | ||||||||
| Address2: | |||||||||
| City: | EAST WINDSOR | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 085201411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6094264442 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2016 | ||||||||
| LastUpdateDate: | 09/01/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 40QA01684100 | NJ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.