Form Physical Therapy Llc

LBN: Form Physical Therapy Llc
Form Physical Therapy Llc is an health care organization with primary practice located at 39 Colonial Woods Dr , West Orange NJ 07052-1614. The organization recently has only one registered license in Ambulatory Health Care Facilities / Physical Therapy, which is considered as the primary health care specialty. Form Physical Therapy Llc can be contacted via phone (732) 221-6703, or through Feller, Michael Thomas via phone (732) 221-6703.

Contact Information

Primary practice address
39 Colonial Woods Dr West Orange NJ 07052-1614
Phone: (732) 221-6703
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Feller, Michael Thomas DPT
Phone: (732) 221-6703

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Physical Therapy 261QP2000X

Profile Details

NPI number 1053254540
LBN Legal business name Form Physical Therapy Llc
DBA Doing business as
Authorized official Feller, Michael Thomas DPT
Entity Organization
Organization subpart 1 No
Enumeration date Apr 10th, 2026
Last updated Apr 10th, 2026 - about 7 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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