Provider Demographics
NPI:1821508748
Name:AMP PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:AMP PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:ERICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:908-705-1027
Mailing Address - Street 1:37 MURRAY DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-2533
Mailing Address - Country:US
Mailing Address - Phone:908-705-1027
Mailing Address - Fax:908-369-1690
Practice Address - Street 1:242 OLD NEW BRUNSWICK RD STE 300
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-3754
Practice Address - Country:US
Practice Address - Phone:908-705-1027
Practice Address - Fax:908-369-1690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-05
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy