Provider Demographics
NPI:1558165902
Name:BACK TO BARBELL SPORTS REHABILITATION AND PERFORMANCE LLC
Entity type:Organization
Organization Name:BACK TO BARBELL SPORTS REHABILITATION AND PERFORMANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CREVANI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:201-455-7417
Mailing Address - Street 1:384 SPRING GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08848-1817
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:224 STOCKTON ST
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-2948
Practice Address - Country:US
Practice Address - Phone:201-455-7417
Practice Address - Fax:833-936-1249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy