Healthcare Provider Details

I. General information

NPI: 1760244578
Provider Name (Legal Business Name): THERAPEUTIC MOVEMENT RX PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2024
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19566 VENTURA BLVD
TARZANA CA
91356-2917
US

IV. Provider business mailing address

19566 VENTURA BLVD
TARZANA CA
91356-2917
US

V. Phone/Fax

Practice location:
  • Phone: 818-445-0280
  • Fax:
Mailing address:
  • Phone: 818-445-0280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. OFEK MILLER
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 818-445-0280