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General NPI Number Information
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NPI Number | 1376927251
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Entity Type | Organization
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Legal Business Name | OPTIMOVE PHYSICAL THERAPY & WELLNESS LLC
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Dates
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Enumeration Date | 07/10/2015
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Last Update Date | 07/10/2015
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Provider Practice Location Address
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Address Line | 2307 GRAVEL DR
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City | FORT WORTH
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State | TX
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Zip | 76118-6951
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Country | US
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Telephone | 469-803-1838
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 141136
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City | DALLAS
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State | TX
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Zip | 75214-1136
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Country | US
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Telephone | 469-803-1838
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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. JEFFREY ROBERT GUILD
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Credential | PT, DPT, CSCS
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Telephone | 469-803-1838
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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 | 1231895
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License Number State | TX
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