Healthcare Provider Details

I. General information

NPI: 1881439917
Provider Name (Legal Business Name): BIG MOVES PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2024
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13094 NC HIGHWAY 50 STE B
SURF CITY NC
28445-6588
US

IV. Provider business mailing address

13094 NC HIGHWAY 50 STE B
SURF CITY NC
28445-6588
US

V. Phone/Fax

Practice location:
  • Phone: 910-803-0054
  • Fax: 910-803-0168
Mailing address:
  • Phone: 910-803-0054
  • Fax: 910-803-0168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA L WATSON
Title or Position: OWNER
Credential: PT, DPT
Phone: 910-803-0054