Provider Demographics
NPI:1063048031
Name:MOVEMENT & MOBILITY EXPERT
Entity type:Organization
Organization Name:MOVEMENT & MOBILITY EXPERT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDON
Authorized Official - Middle Name:M
Authorized Official - Last Name:CAVANAGH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:559-471-9972
Mailing Address - Street 1:2023 W SPUR DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-1722
Mailing Address - Country:US
Mailing Address - Phone:559-471-9972
Mailing Address - Fax:
Practice Address - Street 1:2023 W SPUR DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-1722
Practice Address - Country:US
Practice Address - Phone:559-471-9972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-21
Last Update Date:2020-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty