MS. GINA DAZOS
Restorative Service Providers at Elmwood Ave, Maplewood, NJ

License number
New Jersey 40QB00100800
Category
Restorative Service Providers
Type
Physical Therapy Assistant
Address
Address 2
333 Elmwood Ave, Maplewood, NJ 07040
92 Mildred Ter, Clark, NJ 07066
Phone
(973) 313-2104
(732) 882-6269
National Provider ID: 1548686991
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Personal information

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Name
Address
Phone
Gina Dazos, age 52
92 Mildred Ter, Clark, NJ 07066

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