Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Form Physical Therapy LLC

Organization Physical Therapy Clinic/Center · NPI 1053254540

Form Physical Therapy LLC is a Physical Therapy Clinic/Center in West Orange, New Jersey. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

39 Colonial Woods Dr
West Orange, NJ 07052-1614
Phone: (732) 221-6703
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Clinic/Center (primary) Taxonomy 261QP2000X

Record details

NPI number1053254540
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Feller — Owner/Physical Therapist · (732) 221-6703
NPI enumeratedApril 10, 2026
Last updated in NPPESApril 10, 2026
Certification dateApril 10, 2026
Mailing address39 Colonial Woods Dr, West Orange, NJ 07052-1614

Other providers in West Orange