Healthcare Provider Details

I. General information

NPI: 1790383982
Provider Name (Legal Business Name): FLUID MOVEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2020
Last Update Date: 10/11/2020
Certification Date: 10/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2565 BOWMONT DR
EUGENE OR
97405-1407
US

IV. Provider business mailing address

2565 BOWMONT DR
EUGENE OR
97405-1407
US

V. Phone/Fax

Practice location:
  • Phone: 571-247-6131
  • Fax:
Mailing address:
  • Phone: 571-247-6131
  • 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: DR. LESLIE S GIRARD
Title or Position: OWNER, THERAPIST
Credential: PT
Phone: 571-247-6131