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General NPI Number Information
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NPI Number | 1407551658
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Entity Type | Organization
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Legal Business Name | I.MOVE. HEALTH AND PERFORMANCE
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Dates
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Enumeration Date | 04/04/2023
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Last Update Date | 04/04/2023
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Provider Practice Location Address
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Address Line | 10729 SE 82ND AVE
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City | HAPPY VALLEY
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State | OR
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Zip | 97086-7601
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Country | US
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Telephone | 971-236-4348
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Fax |
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Provider Business Mailing Address
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Address Line | 10729 SE 82ND AVE
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City | HAPPY VALLEY
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State | OR
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Zip | 97086-7601
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Country | US
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Telephone | 971-236-4348
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL CHARLAT
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Credential |
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Telephone | 971-236-4348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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