Provider Demographics
NPI:1720815541
Name:MOVEMENTMT PLLC
Entity type:Organization
Organization Name:MOVEMENTMT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:LAT, ATC, DPT
Authorized Official - Phone:406-399-1878
Mailing Address - Street 1:2402 SUDLOW ST
Mailing Address - Street 2:
Mailing Address - City:MILES CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59301-5037
Mailing Address - Country:US
Mailing Address - Phone:406-399-1878
Mailing Address - Fax:
Practice Address - Street 1:2402 SUDLOW ST
Practice Address - Street 2:
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-5037
Practice Address - Country:US
Practice Address - Phone:406-399-1878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty