Provider Demographics
NPI:1134975931
Name:POWERED UP PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:POWERED UP PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CARLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHLEIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-303-1001
Mailing Address - Street 1:570 PIERMONT ROAD
Mailing Address - Street 2:A-1 #176
Mailing Address - City:CLOSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07624
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:55 WALNUT STREET
Practice Address - Street 2:UNIT 104, SUITES D AND E
Practice Address - City:NORWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07648
Practice Address - Country:US
Practice Address - Phone:201-477-8863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty