Healthcare Provider Details

I. General information

NPI: 1043139298
Provider Name (Legal Business Name): MOVEMENT, MILESTONES, AND MOBILITY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1804 CROSS POINTE WAY
SAINT AUGUSTINE FL
32092-5010
US

IV. Provider business mailing address

1804 CROSS POINTE WAY
SAINT AUGUSTINE FL
32092-5010
US

V. Phone/Fax

Practice location:
  • Phone: 904-868-0404
  • Fax:
Mailing address:
  • Phone:
  • 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: MRS. DEBRA SELLS
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT, ATP
Phone: 904-868-0404