Healthcare Provider Details

I. General information

NPI: 1164178331
Provider Name (Legal Business Name): METAMOVEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2022
Last Update Date: 02/26/2022
Certification Date: 02/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 ROUTE 71
WALL TOWNSHIP NJ
07719-3277
US

IV. Provider business mailing address

608 HOLLY HILL DR
BRIELLE NJ
08730-1217
US

V. Phone/Fax

Practice location:
  • Phone: 908-625-5972
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY T MAHMOOD
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 908-625-5972