MEDICARE: FORWARD MOTION PHYSICAL THERAPY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	7050	AZ

General Provider Information

NPI Number	:	1134361017
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORWARD MOTION PHYSICAL THERAPY PLLC

Provider Business Mailing Address
First Line	:	1370 E ORCHID LN
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85296-4320
Country	:	US
Telephone Number	:	602-380-7047
Fax Number	:

Provider Business Practice Location Address
First Line	:	10631 S 51ST ST
Second Line	:	SUITE 3
City	:	PHOENIX
State	:	AZ
Zip	:	85044-5225
Country	:	US
Telephone Number	:	602-380-7047
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	DR. KRISTEN LYNNE WARREN
Credential	:	PT, DPT
Telephone Number	:	602-380-7047

Provider Enumeration Date	:	03/24/2009
Last Update Date	:	05/29/2014

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