Provider Demographics
NPI:1205727146
Name:MOVEMENT EVOLVED PHYSICAL THERAPY P.C.
Entity type:Organization
Organization Name:MOVEMENT EVOLVED PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RACHAEL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:KEAST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-639-3165
Mailing Address - Street 1:110 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-6802
Mailing Address - Country:US
Mailing Address - Phone:559-779-2763
Mailing Address - Fax:
Practice Address - Street 1:110 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-6802
Practice Address - Country:US
Practice Address - Phone:209-639-3165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty