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NPI Code Detail

MEDICARE: MOBILE MOTION REHAB LLC

MEDICARE: MOBILE MOTION REHAB LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1336072149
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOBILE MOTION REHAB LLC
Provider Business Mailing Address
First Line : 206 BLOOMFIELD AVE APT 404
Second Line :
City : BLOOMFIELD
State : NJ
Zip : 07003-5761
Country : US
Telephone Number : 201-889-0314
Fax Number :
Provider Business Practice Location Address
First Line : 206 BLOOMFIELD AVE APT 404
Second Line :
City : BLOOMFIELD
State : NJ
Zip : 07003-5761
Country : US
Telephone Number : 201-889-0314
Fax Number :
Authorized Official
Title or Position : PHYSICAL THERAPIST
Name : DR. CALLIE EVANCHICK
Credential : DPT
Telephone Number : 201-889-0314
Provider Enumeration Date : 06/03/2026
Last Update Date : 06/03/2026

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Directions to “MOBILE MOTION REHAB LLC ” Practice Location

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