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General NPI Number Information
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NPI Number | 1982281515
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Entity Type | Organization
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Legal Business Name | OPTIMAL MOVEMENT PT
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Dates
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Enumeration Date | 03/28/2021
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Last Update Date | 05/18/2021
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Provider Practice Location Address
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Address Line | 142 ROUTE 23
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-2000
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Country | US
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Telephone | 201-835-4343
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Fax |
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Provider Business Mailing Address
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Address Line | 4 MOUNTAIN AVE
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City | WANAQUE
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State | NJ
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Zip | 07465-1315
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Country | US
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Telephone | 201-835-4343
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Fax |
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Authorized Official
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Title or Position | PT/OWNER
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Name | OLGA KOZA
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Credential | PT,DPT,COMT
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Telephone | 201-835-4343
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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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