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General NPI Number Information
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NPI Number | 1346780392
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Entity Type | Organization
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Legal Business Name | MOVEUP PLLC
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Dates
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Enumeration Date | 02/24/2017
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Last Update Date | 03/23/2017
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Provider Practice Location Address
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Address Line | 5204 JACQUELYN LN SUITE 12
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City | BARTLESVILLE
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State | OK
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Zip | 74006-7733
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Country | US
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Telephone | 918-440-1619
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Fax | 918-876-6545
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Provider Business Mailing Address
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Address Line | 6024 CORNELL DR
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City | BARTLESVILLE
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State | OK
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Zip | 74006-8929
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Country | US
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Telephone | 918-440-1619
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Fax | 918-876-6545
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Authorized Official
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Title or Position | OWNER
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Name | REBECCA RENFRO
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Credential | P.T.
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Telephone | 918-440-1619
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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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