Provider Demographics
NPI:1699259929
Name:LIFE MOVES MANUAL THERAPIES, LLC
Entity type:Organization
Organization Name:LIFE MOVES MANUAL THERAPIES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOECK
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, CES
Authorized Official - Phone:678-883-5668
Mailing Address - Street 1:4321 KINGS WAY NE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-3631
Mailing Address - Country:US
Mailing Address - Phone:727-804-3791
Mailing Address - Fax:
Practice Address - Street 1:1800 ROSWELL RD STE 1050
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-3982
Practice Address - Country:US
Practice Address - Phone:678-883-5668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-21
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center