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General NPI Number Information
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NPI Number | 1194400176
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Entity Type | Organization
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Legal Business Name | MVMT PHYSICAL THERAPY AND PERFORMANCE INC
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 1330 SPECIALTY DR STE E
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City | VISTA
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State | CA
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Zip | 92081-8567
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Country | US
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Telephone | 949-490-0685
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Fax | 949-593-0204
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Provider Business Mailing Address
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Address Line | 3972 BARRANCA PKWY STE J324
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City | IRVINE
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State | CA
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Zip | 92606-1204
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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 | KATHERINE SERRANO
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Credential | PT, DPT
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Telephone | 562-253-7597
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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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