Provider Demographics
NPI:1891556932
Name:MOVEMENT SOCIETY REHAB LLC
Entity type:Organization
Organization Name:MOVEMENT SOCIETY REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:C
Authorized Official - Last Name:DANG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:213-802-7208
Mailing Address - Street 1:1325 PALMETTO ST STE 140
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-2836
Mailing Address - Country:US
Mailing Address - Phone:213-802-7208
Mailing Address - Fax:
Practice Address - Street 1:1325 PALMETTO ST STE 140
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-2836
Practice Address - Country:US
Practice Address - Phone:213-802-7208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy