Basic Information
| Provider Information | |||||||||
| NPI: | 1467457762 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PHYSICAL THERAPY SERVICES OF MORRISTOWN, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 310 MADISON AVE | ||||||||
| Address2: | STE 130 | ||||||||
| City: | MORRISTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079606967 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9732921101 | ||||||||
| FaxNumber: | 9732924149 | ||||||||
| Practice Location | |||||||||
| Address1: | 310 MADISON AVE | ||||||||
| Address2: | STE 130 | ||||||||
| City: | MORRISTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079606967 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9732921101 | ||||||||
| FaxNumber: | 9732924149 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2005 | ||||||||
| LastUpdateDate: | 05/06/2014 | ||||||||
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| AuthorizedOfficialLastName: | TREZZA | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 9732921101 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | PT, MS, DPT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.