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General NPI Number Information
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NPI Number | 1568927028
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Entity Type | Organization
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Legal Business Name | FORWARD MOTION PT, LLC
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Dates
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Enumeration Date | 02/08/2019
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Last Update Date | 02/08/2019
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Provider Practice Location Address
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Address Line | 167 NEWARK POMPTON TPKE
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City | PEQUANNOCK
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State | NJ
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Zip | 07440-1338
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Country | US
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Telephone | 973-454-6065
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Fax |
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Provider Business Mailing Address
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Address Line | 167 NEWARK POMPTON TPKE
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City | PEQUANNOCK
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State | NJ
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Zip | 07440-1338
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Country | US
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Telephone | 973-454-6065
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DANIEL PRATA
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Credential | PT, DPT
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Telephone | 973-454-6065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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