Healthcare Provider Details

I. General information

NPI: 1336749605
Provider Name (Legal Business Name): MOVE FOR LIFE PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2020
Last Update Date: 01/04/2021
Certification Date: 01/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 WASHINGTON ST
HUDSON MA
01749-2775
US

IV. Provider business mailing address

2 W 10TH ST STE 201
MARCUS HOOK PA
19061-4513
US

V. Phone/Fax

Practice location:
  • Phone: 610-663-5888
  • Fax: 800-509-6008
Mailing address:
  • Phone: 610-663-5888
  • Fax: 800-509-6008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MELISSA PENROSE
Title or Position: MANAGER
Credential:
Phone: 610-663-5888