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General NPI Number Information
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NPI Number | 1750717922
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Entity Type | Organization
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Legal Business Name | MOVEIT PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 09/19/2013
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Last Update Date | 09/19/2013
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Provider Practice Location Address
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Address Line | 665 ASPEN HEIGHTS DR
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City | FAIRBANKS
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State | AK
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Zip | 99712-1111
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Country | US
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Telephone | 907-388-0692
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Fax |
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Provider Business Mailing Address
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Address Line | 315 BARNETTE ST #74638
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City | FAIRBANKS
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State | AK
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Zip | 99707-4638
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Country | US
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Telephone | 907-388-0692
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | RUTH ELIZABETH LYLE
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Credential |
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Telephone | 907-388-0692
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 170
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License Number State | AK
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