Provider Demographics
NPI:1255686291
Name:WELLNESS IN MOTION PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:WELLNESS IN MOTION PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIOCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-521-3272
Mailing Address - Street 1:6 MUIRFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROE TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-5147
Mailing Address - Country:US
Mailing Address - Phone:732-521-3272
Mailing Address - Fax:
Practice Address - Street 1:561 CRANBURY RD.
Practice Address - Street 2:SUITE B
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5400
Practice Address - Country:US
Practice Address - Phone:848-228-9536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-16
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00819700225100000X
NJ40QA00797300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty