Healthcare Provider Details
I. General information
NPI: 1235735887
Provider Name (Legal Business Name): MOVE PHYSICAL THERAPY AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/09/2020
Last Update Date: 09/17/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
803 HARKRIDER ST STE 6
CONWAY AR
72032-5690
US
IV. Provider business mailing address
803 HARKRIDER ST STE 6
CONWAY AR
72032-5690
US
V. Phone/Fax
- Phone: 501-358-6170
- Fax: 501-358-6190
- Phone: 501-358-6170
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVEN
SETH
HARRELL
Title or Position: DPT/OWNER
Credential: DPT
Phone: 501-358-6170