Healthcare Provider Details

I. General information

NPI: 1770402596
Provider Name (Legal Business Name): FORWARD MOTION ENTERPRISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12611 DEATON HILL DR
CHARLOTTE NC
28269-0991
US

IV. Provider business mailing address

12611 DEATON HILL DR
CHARLOTTE NC
28269-0991
US

V. Phone/Fax

Practice location:
  • Phone: 704-615-0606
  • Fax:
Mailing address:
  • Phone: 704-615-0606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLISS L. MURRY
Title or Position: OWNER
Credential:
Phone: 704-615-0606