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General NPI Number Information
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NPI Number | 1023489531
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Entity Type | Organization
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Legal Business Name | MOVEMENT VALUED MANUAL THERAPY PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 10/09/2015
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Last Update Date | 04/25/2021
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Provider Practice Location Address
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Address Line | 35 W 35TH ST RM 301
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City | NEW YORK
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State | NY
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Zip | 10001-2249
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Country | US
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Telephone | 646-430-5717
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Fax | 646-514-1972
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Provider Business Mailing Address
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Address Line | 35 W 35TH ST RM 301
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City | NEW YORK
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State | NY
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Zip | 10001-2249
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Country | US
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Telephone | 646-430-5717
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Fax | 646-514-1972
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Authorized Official
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Title or Position | PRESIDENT, PHYSICAL THERAPIST
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Name | MR. MARK M LUSK
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Credential | DPT
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Telephone | 646-430-5717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 031569
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License Number State | NY
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