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General NPI Number Information
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NPI Number | 1134975931
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Entity Type | Organization
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Legal Business Name | POWERED UP PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 04/24/2024
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 55 WALNUT STREET UNIT 104, SUITES D AND E
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City | NORWOOD
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State | NJ
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Zip | 07648
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Country | US
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Telephone | 201-477-8863
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Fax |
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Provider Business Mailing Address
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Address Line | 570 PIERMONT ROAD A-1 #176
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City | CLOSTER
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State | NJ
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Zip | 07624
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | CARLEY SCHLEIEN
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Credential |
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Telephone | 786-303-1001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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