Healthcare Provider Details

I. General information

NPI: 1013468677
Provider Name (Legal Business Name): THE MOVEMENT SCIENCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2016
Last Update Date: 10/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 OCHSNER BLVD SUITE A
COVINGTON LA
70433-8147
US

IV. Provider business mailing address

321 VETERANS MEMORIAL BLVD SUITE 100
METAIRIE LA
70005-3026
US

V. Phone/Fax

Practice location:
  • Phone: 985-801-7145
  • Fax:
Mailing address:
  • Phone: 504-834-9259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number25251134
License Number StateLA

VIII. Authorized Official

Name: MARIANNE FRY
Title or Position: CAO
Credential:
Phone: 504-834-9259