Healthcare Provider Details

I. General information

NPI: 1922814714
Provider Name (Legal Business Name): BUILT TO MOVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2024
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2405 STATE ROUTE 71 STE B
SPRING LAKE NJ
07762-2251
US

IV. Provider business mailing address

3 SALT WORKS ST
NEPTUNE NJ
07753-7033
US

V. Phone/Fax

Practice location:
  • Phone: 732-592-9064
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CAITLIN LONG
Title or Position: OWNER
Credential:
Phone: 732-592-9064