Healthcare Provider Details
I. General information
NPI: 1215544390
Provider Name (Legal Business Name): PAIN FREE MOVEMENT L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/23/2020
Last Update Date: 09/24/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7324 SOUTHWEST FWY STE 325
HOUSTON TX
77074-2058
US
IV. Provider business mailing address
6520 BROADWAY ST APT 322
PEARLAND TX
77581-7720
US
V. Phone/Fax
- Phone: 832-930-2970
- Fax:
- Phone: 228-229-0156
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0401X |
| Taxonomy | Comprehensive Outpatient Rehabilitation Facility (CORF) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JEROME
ALLEN
JR.
Title or Position: OWNER
Credential: EXERCISE SPECIAIST
Phone: 832-930-2970