Provider Demographics
NPI:1174294276
Name:ALTERNATIVE MANUAL PHYSICAL THERAPY AND MASSAGE
Entity Type:Organization
Organization Name:ALTERNATIVE MANUAL PHYSICAL THERAPY AND MASSAGE
Other - Org Name:ALTERNATIVE MANUAL PHYSICAL THERAPY AND MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSHEFF
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:732-642-5055
Mailing Address - Street 1:1500 DAHLIA CT
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-4132
Mailing Address - Country:US
Mailing Address - Phone:732-642-5055
Mailing Address - Fax:732-370-4475
Practice Address - Street 1:864 ROUTE 37 W
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5033
Practice Address - Country:US
Practice Address - Phone:732-642-5055
Practice Address - Fax:732-370-4475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-28
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty