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General NPI Number Information
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NPI Number | 1255686291
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Entity Type | Organization
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Legal Business Name | WELLNESS IN MOTION PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 07/16/2012
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Last Update Date | 08/02/2012
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Provider Practice Location Address
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Address Line | 561 CRANBURY RD. SUITE B
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-5400
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Country | US
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Telephone | 848-228-9536
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Fax |
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Provider Business Mailing Address
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Address Line | 6 MUIRFIELD BLVD
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City | MONROE TWP
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State | NJ
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Zip | 08831-5147
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Country | US
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Telephone | 732-521-3272
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MARIA SIOCHI
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Credential |
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Telephone | 732-521-3272
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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 | 40QA00819700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA00797300
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License Number State | NJ
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