Provider Demographics
NPI:1255951877
Name:PHYSIOPROS PHYSICAL THERAPY & WELLNESS
Entity type:Organization
Organization Name:PHYSIOPROS PHYSICAL THERAPY & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:973-713-3805
Mailing Address - Street 1:49 OVERLOOK RD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-5805
Mailing Address - Country:US
Mailing Address - Phone:973-713-3805
Mailing Address - Fax:
Practice Address - Street 1:49 OVERLOOK RD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-5805
Practice Address - Country:US
Practice Address - Phone:973-713-3805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty