Provider Demographics
NPI:1205858321
Name:M & M PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:M & M PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:LYONS-MARCUS
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:856-988-7999
Mailing Address - Street 1:773 E ROUTE 70
Mailing Address - Street 2:SUITE E125
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2362
Mailing Address - Country:US
Mailing Address - Phone:856-988-7999
Mailing Address - Fax:
Practice Address - Street 1:773 E ROUTE 70
Practice Address - Street 2:SUITE E125
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2362
Practice Address - Country:US
Practice Address - Phone:856-988-7999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00410400261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ093689Medicare ID - Type UnspecifiedSTEVEN PLATT, PT
NJ117980Medicare ID - Type UnspecifiedRUTH MARCUS, PT
NJ083503Medicare ID - Type UnspecifiedBRETT MICHENER, PT
NJ083503W22Medicare PIN
NJ093689W22Medicare PIN
NJ115951Medicare PIN
NJ117980W22Medicare PIN