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General NPI Number Information
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NPI Number | 1396405890
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Entity Type | Organization
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Legal Business Name | MOVEMENT REDEFINED LLC
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Dates
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Enumeration Date | 12/23/2021
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Last Update Date | 12/23/2021
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Provider Practice Location Address
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Address Line | 10050 N SCOTTSDALE RD STE 111
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City | SCOTTSDALE
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State | AZ
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Zip | 85253-1498
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Country | US
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Telephone | 602-592-0940
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Fax |
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Provider Business Mailing Address
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Address Line | 4324 E BERKELEY RD
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City | PHOENIX
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State | AZ
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Zip | 85008-4087
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Country | US
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Telephone | 602-592-0940
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Fax |
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | DR. BEN BARRANTES
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Credential | DPT
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Telephone | 602-592-0940
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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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