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General NPI Number Information
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NPI Number | 1104084805
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Entity Type | Organization
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Legal Business Name | MAXIMIZING MOVEMENT THERAPY SERVICES INC.
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Dates
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Enumeration Date | 05/29/2008
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Last Update Date | 05/29/2008
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Provider Practice Location Address
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Address Line | 320 S ROBERTS RD
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City | BRYN MAWR
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State | PA
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Zip | 19010-1238
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Country | US
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Telephone | 610-639-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 1105 GARFIELD AVE
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City | HAVERTOWN
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State | PA
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Zip | 19083-3436
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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 | PRESIDENT
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Name | DR. KRISTY BOYD
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Credential |
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Telephone | 484-454-5125
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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 | PT015804
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License Number State | PA
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