Healthcare Provider Details

I. General information

NPI: 1891556932
Provider Name (Legal Business Name): MOVEMENT SOCIETY REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2024
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 PALMETTO ST STE 140
LOS ANGELES CA
90013-2836
US

IV. Provider business mailing address

1325 PALMETTO ST STE 140
LOS ANGELES CA
90013-2836
US

V. Phone/Fax

Practice location:
  • Phone: 213-802-7208
  • Fax:
Mailing address:
  • Phone: 213-802-7208
  • 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: TONY C DANG
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: DPT
Phone: 213-802-7208