Healthcare Provider Details

I. General information

NPI: 1205793312
Provider Name (Legal Business Name): MOVE PHYSICAL THERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11663 KIOWA AVE APT 201
LOS ANGELES CA
90049-6230
US

IV. Provider business mailing address

11663 KIOWA AVE APT 201
LOS ANGELES CA
90049-6230
US

V. Phone/Fax

Practice location:
  • Phone: 206-225-4415
  • Fax:
Mailing address:
  • Phone: 206-225-4415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH KOMET
Title or Position: CEO, FOUNDER
Credential: PT, DPT, CSCS
Phone: 206-225-4415