Healthcare Provider Details

I. General information

NPI: 1770496317
Provider Name (Legal Business Name): NEURO MOTION THERAPY & FITNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 10TH ST
DAYTONA BEACH FL
32117-3366
US

IV. Provider business mailing address

606 10TH ST
HOLLY HILL FL
32117-3366
US

V. Phone/Fax

Practice location:
  • Phone: 386-299-4171
  • Fax:
Mailing address:
  • Phone: 386-299-4171
  • 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: MS. OLGA BECKWITH
Title or Position: OWNER
Credential: PTA
Phone: 386-299-4171