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General NPI Number Information
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NPI Number | 1821428418
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Entity Type | Organization
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Legal Business Name | MOVEVOLUTION, INC
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Dates
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Enumeration Date | 11/18/2013
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Last Update Date | 03/27/2014
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Provider Practice Location Address
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Address Line | 87 FORT GREENE PL 2ND FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11217-1203
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Country | US
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Telephone | 718-522-2658
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Fax |
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Provider Business Mailing Address
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Address Line | 87 FORT GREENE PL 2ND FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11217-1203
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Country | US
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Telephone | 718-522-2658
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. RICHARD SYMISTER
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Credential | MSPT
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Telephone | 718-916-0526
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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 | 0227091
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License Number State | NY
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