Provider Demographics
NPI:1811326986
Name:PLYO PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:PLYO PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RITCHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:201-934-1281
Mailing Address - Street 1:115 W ALLENDALE AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ALLENDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07401-1734
Mailing Address - Country:US
Mailing Address - Phone:201-934-1281
Mailing Address - Fax:201-622-0701
Practice Address - Street 1:115 W ALLENDALE AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:ALLENDALE
Practice Address - State:NJ
Practice Address - Zip Code:07401-1734
Practice Address - Country:US
Practice Address - Phone:201-934-1281
Practice Address - Fax:201-622-0701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-08
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01326100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty