MEDICARE: GREAT MOVEMENTS, LLC

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	225XP0019X	Physical Rehabilitation Occupational Therapist	OTP-OT-LIC-4690	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14149457	OTHER		CAQH ID

General Provider Information

NPI Number	:	1801391354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREAT MOVEMENTS, LLC

Provider Business Mailing Address
First Line	:	1013 35TH AVE NE
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-1214
Country	:	US
Telephone Number	:	317-250-0997
Fax Number	:

Provider Business Practice Location Address
First Line	:	1013 35TH AVE NE
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-1214
Country	:	US
Telephone Number	:	317-250-0997
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTINE SCHRAGE
Credential	:	MS, OTR
Telephone Number	:	317-250-0997

Provider Enumeration Date	:	03/27/2018
Last Update Date	:	06/16/2018

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Directions to “GREAT MOVEMENTS, LLC ” Practice Location

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