Provider Demographics
NPI:1467276816
Name:MOJO PT & PILATES PLLC
Entity type:Organization
Organization Name:MOJO PT & PILATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAX
Authorized Official - Middle Name:S
Authorized Official - Last Name:OSCAR
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:845-263-4917
Mailing Address - Street 1:9 MURRAY RD
Mailing Address - Street 2:
Mailing Address - City:ESSEX JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05452-3011
Mailing Address - Country:US
Mailing Address - Phone:845-263-4917
Mailing Address - Fax:
Practice Address - Street 1:159 PEARL ST STE 4
Practice Address - Street 2:
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-3038
Practice Address - Country:US
Practice Address - Phone:845-263-4917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty