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General NPI Number Information
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NPI Number | 1700442928
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Entity Type | Organization
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Legal Business Name | MOVEMENT UPGRADED LLC
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Dates
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Enumeration Date | 05/13/2019
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Last Update Date | 07/18/2019
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Provider Practice Location Address
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Address Line | 3420 W MAIN ST
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City | TAMPA
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State | FL
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Zip | 33607-4223
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Country | US
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Telephone | 813-563-7301
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Fax |
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Provider Business Mailing Address
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Address Line | 4310 W SPRUCE ST UNIT 453
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City | TAMPA
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State | FL
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Zip | 33607-4274
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Country | US
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Telephone | 813-563-7301
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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. RYAN HOSLER
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Credential | DC
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Telephone | 260-224-8282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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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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