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General NPI Number Information
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NPI Number | 1104719194
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Entity Type | Organization
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Legal Business Name | MOVEMENT & MOBILITY LAB
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 1025 W H SMITH BLVD STE 106
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City | GREENVILLE
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State | NC
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Zip | 27834-5278
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Country | US
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Telephone | 252-215-2215
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Fax |
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Provider Business Mailing Address
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Address Line | 910 CONSOLE LN
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City | KILL DEVIL HILLS
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State | NC
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Zip | 27948-9478
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Country | US
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Telephone | 919-916-0181
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | DR. ELIZABETH BRENNAN
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Credential | PT, DPT
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Telephone | 919-916-0181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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