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General NPI Number Information
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NPI Number | 1770849374
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Entity Type | Organization
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Legal Business Name | MOVE IT THERAPY, LLC
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Dates
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Enumeration Date | 04/09/2012
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Last Update Date | 07/11/2012
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Provider Practice Location Address
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Address Line | 3499 S LINDEN RD SUITE # 5
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City | FLINT
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State | MI
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Zip | 48507-3022
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Country | US
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Telephone | 810-766-9944
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Fax |
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Provider Business Mailing Address
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Address Line | 3499 S LINDEN RD SUITE #5
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City | FLINT
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State | MI
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Zip | 48507-3022
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Country | US
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Telephone | 810-766-9944
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. REBECCA A. STODDARD
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Credential | OTRL
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Telephone | 810-766-9944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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