Provider Demographics
NPI:1558406686
Name:FOCUS PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:FOCUS PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:VRSALOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:973-509-0827
Mailing Address - Street 1:552 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-1805
Mailing Address - Country:US
Mailing Address - Phone:973-509-0827
Mailing Address - Fax:973-509-0877
Practice Address - Street 1:552 VALLEY RD
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1805
Practice Address - Country:US
Practice Address - Phone:973-509-0827
Practice Address - Fax:973-509-0877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00038000171100000X
NJ40QA01116800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty