Provider Demographics
NPI:1699512806
Name:ON THE MOVE THERAPY & WELLNESS
Entity type:Organization
Organization Name:ON THE MOVE THERAPY & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:REECE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARANDA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:612-708-1261
Mailing Address - Street 1:PO BOX 5
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-0005
Mailing Address - Country:US
Mailing Address - Phone:612-708-1261
Mailing Address - Fax:
Practice Address - Street 1:6471 INSPIRE CIR S
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55016-4692
Practice Address - Country:US
Practice Address - Phone:612-708-1261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy