Provider Demographics
NPI:1427837897
Name:MOVEMENT PROFESSIONALS PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:MOVEMENT PROFESSIONALS PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:P
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:386-847-2225
Mailing Address - Street 1:711 KRISTINA CT
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-4907
Mailing Address - Country:US
Mailing Address - Phone:386-847-2225
Mailing Address - Fax:
Practice Address - Street 1:711 KRISTINA CT
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-4907
Practice Address - Country:US
Practice Address - Phone:386-847-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy