Healthcare Provider Details

I. General information

NPI: 1235605874
Provider Name (Legal Business Name): MOVEMENT CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2018
Last Update Date: 08/10/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 E VAN TREES ST
WASHINGTON IN
47501-2943
US

IV. Provider business mailing address

1047 N STATE ROAD 57
WASHINGTON IN
47501-7561
US

V. Phone/Fax

Practice location:
  • Phone: 812-254-2203
  • Fax: 812-254-2033
Mailing address:
  • Phone: 812-254-2203
  • Fax: 812-254-2033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JESS THOMAS BROWER
Title or Position: PRESIDENT
Credential: DC
Phone: 812-254-2203