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NPI 1629747894

NPI 1629747894 : MOVE AND IMPROVE PT LLC : COLUMBUS, OH

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General NPI Number Information
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    NPI Number           |    1629747894
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    Entity Type          |    Organization 
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    Legal Business Name  |    MOVE AND IMPROVE PT LLC 
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Dates
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    Enumeration Date     |    09/10/2021
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    Last Update Date     |    09/10/2021
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Provider Practice Location Address
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    Address Line         |    543 E BEECHWOLD BLVD 
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    City                 |    COLUMBUS
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    State                |    OH
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    Zip                  |    43214-1803
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    Country              |    US
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    Telephone            |    919-452-6210
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    543 E BEECHWOLD BLVD 
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    City                 |    COLUMBUS
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    State                |    OH
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    Zip                  |    43214-1803
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    Country              |    US
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    Telephone            |    919-452-6210
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. JOEL KENT SIVILLO 
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    Credential           |    PT, DPT
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    Telephone            |    919-452-6210
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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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