Provider Demographics
NPI:1396278545
Name:MOVEMENT FIRST
Entity type:Organization
Organization Name:MOVEMENT FIRST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:DEDERICH
Authorized Official - Suffix:
Authorized Official - Credentials:MPT, MS, ATC
Authorized Official - Phone:949-261-6101
Mailing Address - Street 1:2290 SE BRISTOL ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-0746
Mailing Address - Country:US
Mailing Address - Phone:949-261-6101
Mailing Address - Fax:949-261-6126
Practice Address - Street 1:2290 SE BRISTOL ST
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-0746
Practice Address - Country:US
Practice Address - Phone:949-261-6101
Practice Address - Fax:949-261-6126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty