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General NPI Number Information
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NPI Number | 1073225876
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Entity Type | Organization
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Legal Business Name | MOVEMENT LAB SPORTS PHYSICAL THERAPY
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Dates
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Enumeration Date | 12/23/2022
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Last Update Date | 12/23/2022
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Provider Practice Location Address
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Address Line | 7601 BOULEVARD 26 STE 121
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76180-8350
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Country | US
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Telephone | 817-264-6868
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Fax |
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Provider Business Mailing Address
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Address Line | 404 4TH ST
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City | WHITESBORO
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State | TX
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Zip | 76273-1021
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | JACOB ROBINSON
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Credential | PT, DPT
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Telephone | 903-818-9421
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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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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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