Provider Demographics
NPI:1699888396
Name:MOVEMENT SCIENCE, INC
Entity type:Organization
Organization Name:MOVEMENT SCIENCE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:V
Authorized Official - Last Name:MCKINNIE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:678-935-7357
Mailing Address - Street 1:2107 N DECATUR RD # 422
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-5305
Mailing Address - Country:US
Mailing Address - Phone:678-935-7357
Mailing Address - Fax:678-623-3292
Practice Address - Street 1:550 FAIRBURN RD SW
Practice Address - Street 2:SUITE B-1
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-2014
Practice Address - Country:US
Practice Address - Phone:404-696-4449
Practice Address - Fax:404-696-3422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT007467225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6381Medicare ID - Type Unspecified