{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "MOVEIT PHYSICAL THERAPY, LLC",
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"FirstLineMailingAddress": "315 BARNETTE ST",
"SecondLineMailingAddress": "#74638",
"MailingAddressCityName": "FAIRBANKS",
"MailingAddressStateName": "AK",
"MailingAddressPostalCode": "99707-4638",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "907-388-0692",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "665 ASPEN HEIGHTS DR",
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"PracticeLocationAddressCityName": "FAIRBANKS",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/19/2013",
"LastUpdateDate": "09/19/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LYLE",
"AuthorizedOfficialFirstName": "RUTH",
"AuthorizedOfficialMiddleName": "ELIZABETH",
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"AuthorizedOfficialTelephoneNumber": "907-388-0692",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": "170",
"LicenseNumberStateCode": "AK",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}