Healthcare Provider Details

I. General information

NPI: 1619948676
Provider Name (Legal Business Name): JOINT MOTION, L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2006
Last Update Date: 02/10/2020
Certification Date: 02/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

373 PARK AVE JOINT MOTION, L.L.C.
SCOTCH PLAINS NJ
07076-0707
US

IV. Provider business mailing address

373 PARK AVE
SCOTCH PLAINS NJ
07076-1152
US

V. Phone/Fax

Practice location:
  • Phone: 908-322-3202
  • Fax: 908-322-3252
Mailing address:
  • Phone: 908-322-3202
  • Fax: 908-322-3252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number40QA00939500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number40QA00939500
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00939500
License Number StateNJ

VIII. Authorized Official

Name: MR. TRISTON STAVROS GLYNOS
Title or Position: OWNER
Credential: PT
Phone: 908-322-3202