Provider Demographics
NPI:1316322803
Name:MOVING FORWARD PHYSICAL THERAPY
Entity type:Organization
Organization Name:MOVING FORWARD PHYSICAL THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOUTING
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:313-815-7599
Mailing Address - Street 1:828 PEMBERTON RD
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48230-1730
Mailing Address - Country:US
Mailing Address - Phone:313-815-7599
Mailing Address - Fax:313-432-0241
Practice Address - Street 1:828 PEMBERTON RD
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE PARK
Practice Address - State:MI
Practice Address - Zip Code:48230-1730
Practice Address - Country:US
Practice Address - Phone:313-815-7599
Practice Address - Fax:313-432-0241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-25
Last Update Date:2015-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55010140392251P0200X, 2251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty