Provider Demographics
NPI:1811783624
Name:JOINT POTENTIAL PHYSICAL THERAPY AND TRAINING CENTER LLC
Entity type:Organization
Organization Name:JOINT POTENTIAL PHYSICAL THERAPY AND TRAINING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:S
Authorized Official - Last Name:SAMALA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:914-450-3850
Mailing Address - Street 1:721 CHARNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-1011
Mailing Address - Country:US
Mailing Address - Phone:201-818-3179
Mailing Address - Fax:201-818-3179
Practice Address - Street 1:755 US HIGHWAY 46
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-3458
Practice Address - Country:US
Practice Address - Phone:914-450-3850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy