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General NPI Number Information
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NPI Number | 1538532148
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Entity Type | Organization
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Legal Business Name | MOVEMENT SCIENCE PHYSICAL THERAPY AND FITNESS INC
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Dates
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Enumeration Date | 11/04/2015
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Last Update Date | 11/08/2015
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Provider Practice Location Address
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Address Line | 145 VISTA AVE SUITE 103
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City | PASADENA
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State | CA
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Zip | 91107-3607
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Country | US
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Telephone | 626-365-1380
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Fax |
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Provider Business Mailing Address
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Address Line | 145 VISTA AVE SUITE 103
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City | PASADENA
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State | CA
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Zip | 91107-3607
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JASON HAN
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Credential | PT
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Telephone | 626-365-1380
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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 | PT 36996
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC 32302
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License Number State | CA
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