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General NPI Number Information
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NPI Number | 1043830961
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Entity Type | Organization
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Legal Business Name | MOVEMENT SPACE PHYSICAL THERAPY
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Dates
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Enumeration Date | 04/21/2020
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Last Update Date | 01/13/2022
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Provider Practice Location Address
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Address Line | 1811 OAK ST STE 150
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City | BAKERSFIELD
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State | CA
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Zip | 93301-3064
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Country | US
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Telephone | 612-414-0896
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Fax | 661-365-0152
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Provider Business Mailing Address
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Address Line | 2316 GOSFORD RD APT X
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City | BAKERSFIELD
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State | CA
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Zip | 93309-5399
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Country | US
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Telephone | 615-655-3198
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Fax | 661-365-0152
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Authorized Official
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Title or Position | OWNER
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Name | HOLLY COMPTON
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Credential | PT, DPT
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Telephone | 615-655-3198
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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 |
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License Number State |
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