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General NPI Number Information
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NPI Number | 1881307932
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Entity Type | Organization
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Legal Business Name | CENTER FOR PEDIATRIC MOVEMENT LLC
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Dates
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Enumeration Date | 01/04/2023
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Last Update Date | 12/19/2023
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Provider Practice Location Address
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Address Line | 6600 FRANCE AVE S STE 164
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City | EDINA
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State | MN
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Zip | 55435-1802
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Country | US
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Telephone | 612-889-0973
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Fax |
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Provider Business Mailing Address
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Address Line | 6432 WILRYAN AVE
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City | EDINA
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State | MN
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Zip | 55439-1446
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Country | US
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Telephone | 612-889-0973
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICOLE HOFFMAN
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Credential |
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Telephone | 612-889-0973
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #3
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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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