Provider Demographics
NPI:1770030322
Name:MEGAMOTION PHYSICAL THERAPY
Entity Type:Organization
Organization Name:MEGAMOTION PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCELLANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-293-5803
Mailing Address - Street 1:3514 CRAID ROAD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NY
Mailing Address - Zip Code:13323-3912
Mailing Address - Country:US
Mailing Address - Phone:352-293-5803
Mailing Address - Fax:
Practice Address - Street 1:73 N. MAINT STREET
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NY
Practice Address - Zip Code:13807
Practice Address - Country:US
Practice Address - Phone:352-293-5803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy