Provider Demographics
NPI:1477955938
Name:ADVANCED MOTION PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:ADVANCED MOTION PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:HEIDI
Authorized Official - Last Name:MILLNER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS
Authorized Official - Phone:973-271-8342
Mailing Address - Street 1:126 BROOK VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-3321
Mailing Address - Country:US
Mailing Address - Phone:973-271-8342
Mailing Address - Fax:
Practice Address - Street 1:126 BROOK VALLEY RD
Practice Address - Street 2:
Practice Address - City:KINNELON
Practice Address - State:NJ
Practice Address - Zip Code:07405-3321
Practice Address - Country:US
Practice Address - Phone:973-271-8342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-16
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01251000261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy