Provider Demographics
NPI:1194355727
Name:MOVEMENT RE-EDUCATION CENTER
Entity type:Organization
Organization Name:MOVEMENT RE-EDUCATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NASH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:406-585-1213
Mailing Address - Street 1:PO BOX 1841
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59771-1841
Mailing Address - Country:US
Mailing Address - Phone:406-570-1848
Mailing Address - Fax:
Practice Address - Street 1:6410 S 3RD RD
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-8352
Practice Address - Country:US
Practice Address - Phone:406-585-1213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty