| Fulcrum Performance Lab, LLC | |
|
75 S Maple Ave Marlton NJ 08053-2032 | |
| (856) 607-2400 | |
| Not Available |
| Full Name | Fulcrum Performance Lab, LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 75 S Maple Ave, Marlton, New Jersey |
| Authorized Official Name and Position | Charles Bruce Morris (CHAIRMAN / CEO) |
| Authorized Official Contact | 6092845456 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fulcrum Performance Lab, LLC 75 S Maple Ave Marlton NJ 08053-2032 Ph: (856) 607-2400 | Fulcrum Performance Lab, LLC 75 S Maple Ave Marlton NJ 08053-2032 Ph: (856) 607-2400 |
| NPI Number | 1205464823 |
|---|---|
| Provider Enumeration Date | 03/30/2020 |
| Last Update Date | 07/17/2020 |
| Certification Date | 07/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205464823 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
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