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General NPI Number Information
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NPI Number | 1689289324
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Entity Type | Organization
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Legal Business Name | ACTIVE LIFE PHYSICAL THERAPY
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Dates
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Enumeration Date | 09/10/2020
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Last Update Date | 03/01/2023
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Provider Practice Location Address
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Address Line | 1346 MAIN AVE STE 3
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City | CLIFTON
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State | NJ
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Zip | 07011-2222
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Country | US
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Telephone | 973-513-5668
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Fax | 973-710-3321
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Provider Business Mailing Address
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Address Line | 1346 MAIN AVE STE 3
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City | CLIFTON
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State | NJ
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Zip | 07011-2222
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Country | US
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Telephone | 973-513-5668
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Fax | 973-710-3310
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Authorized Official
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Title or Position | OWNER
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Name | BELINDA BEILMAN
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Credential | DPT
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Telephone | 197-351-3566
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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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