Provider Demographics
NPI:1265023014
Name:OPTIMUM THERAPY LLC
Entity Type:Organization
Organization Name:OPTIMUM THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDINGIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:630-398-1430
Mailing Address - Street 1:148 RICHFIELD TER APT C
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1385
Mailing Address - Country:US
Mailing Address - Phone:630-398-1430
Mailing Address - Fax:
Practice Address - Street 1:148 RICHFIELD TER APT C
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1385
Practice Address - Country:US
Practice Address - Phone:630-398-1430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty