Provider Demographics
NPI:1295889467
Name:PRO MOTION PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:PRO MOTION PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:908-684-4700
Mailing Address - Street 1:PO BOX 417
Mailing Address - Street 2:
Mailing Address - City:ALLAMUCHY
Mailing Address - State:NJ
Mailing Address - Zip Code:07820-0417
Mailing Address - Country:US
Mailing Address - Phone:908-684-4700
Mailing Address - Fax:
Practice Address - Street 1:1001 ROUTE 517
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2730
Practice Address - Country:US
Practice Address - Phone:908-684-4700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3674616Medicare ID - Type Unspecified