Provider Demographics
NPI:1326193665
Name:BACK IN MOTION PHYSICAL THERAPY, PC.
Entity Type:Organization
Organization Name:BACK IN MOTION PHYSICAL THERAPY, PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:THARWAT
Authorized Official - Middle Name:S
Authorized Official - Last Name:SAID
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:732-246-0665
Mailing Address - Street 1:5 ABATE CT
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-7353
Mailing Address - Country:US
Mailing Address - Phone:732-246-0665
Mailing Address - Fax:732-246-0776
Practice Address - Street 1:79 VERONICA AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3448
Practice Address - Country:US
Practice Address - Phone:732-246-0665
Practice Address - Fax:732-246-0776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00575800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty