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General NPI Number Information
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NPI Number | 1306338744
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Entity Type | Organization
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Legal Business Name | LIVE TO MOVE LLC
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Dates
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Enumeration Date | 06/01/2018
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 11540 MAGNOLIA PARKWAY SUITE G
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City | MANVEL
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State | TX
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Zip | 77578
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Country | US
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Telephone | 979-253-0360
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Fax | 281-213-0324
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Provider Business Mailing Address
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Address Line | 11540 MAGNOLIA PKWY STE G
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City | MANVEL
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State | TX
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Zip | 77578-1649
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Country | US
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Telephone | 281-213-0642
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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 | JAMES MATTHEW POENITZSCH
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Credential | PT, DPT, COMT, CSCS
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Telephone | 281-213-0642
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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 | TX
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