MEDICARE: MUSKEGON MOVEMENT 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

General Provider Information

NPI Number	:	1578493862
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MUSKEGON MOVEMENT PHYSICAL THERAPY PLLC

Provider Business Mailing Address
First Line	:	975 W BROADWAY AVE
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49441-3579
Country	:	US
Telephone Number	:	239-877-7901
Fax Number	:

Provider Business Practice Location Address
First Line	:	975 W BROADWAY AVE
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49441-3579
Country	:	US
Telephone Number	:	239-877-7901
Fax Number	:

Authorized Official
Title or Position	:	MANAGING OWNER
Name	:	EMMANUEL PAGKANLUNGAN
Credential	:	PT, DPT
Telephone Number	:	239-877-7901

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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