Provider Demographics
NPI:1538783345
Name:DYNAMIC MOTION PHYSICAL THERAPY
Entity type:Organization
Organization Name:DYNAMIC MOTION PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PT
Authorized Official - Prefix:
Authorized Official - First Name:PATRYCJA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, PT
Authorized Official - Phone:201-724-4627
Mailing Address - Street 1:201 OAKDENE PL APT F1
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-2258
Mailing Address - Country:US
Mailing Address - Phone:201-724-4627
Mailing Address - Fax:
Practice Address - Street 1:201 OAKDENE PL APT F1
Practice Address - Street 2:
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010-2258
Practice Address - Country:US
Practice Address - Phone:201-724-4627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty