Healthcare Provider Details
I. General information
NPI: 1295698975
Provider Name (Legal Business Name): MOVEFITRX, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
30 N GOULD ST STE N
SHERIDAN WY
82801-6317
US
IV. Provider business mailing address
30 N GOULD ST STE N
SHERIDAN WY
82801-6317
US
V. Phone/Fax
- Phone: 310-384-9112
- Fax:
- Phone: 310-384-9112
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 374700000X |
| Taxonomy | Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GARRETT
JAMES
BORUNDA
Title or Position: CEO
Credential:
Phone: 310-384-9112