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General NPI Number Information
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NPI Number | 1053482398
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Entity Type | Organization
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Legal Business Name | MOVING FORWARD REHABILITATION INC
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 13690 N US HIGHWAY 441 SUITE 400
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City | LADY LAKE
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State | FL
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Zip | 32159-6810
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Country | US
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Telephone | 352-751-3781
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Fax | 352-751-0169
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Provider Business Mailing Address
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Address Line | 13690 N US HIGHWAY 441 SUITE 400
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City | LADY LAKE
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State | FL
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Zip | 32159-6810
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Country | US
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Telephone | 352-751-3781
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Fax | 352-751-0169
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW ABBOTT
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Credential | PT
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Telephone | 352-751-3781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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