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General NPI Number Information
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NPI Number | 1902031594
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Entity Type | Organization
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Legal Business Name | MOVEMENT SYSTEMS PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 05/26/2009
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Last Update Date | 05/26/2009
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Provider Practice Location Address
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Address Line | 17050 BUSHARD ST SUITE 350
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-2832
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Country | US
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Telephone | 714-425-5046
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Fax |
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Provider Business Mailing Address
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Address Line | 17050 BUSHARD ST SUITE 350
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-2832
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Country | US
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Telephone | 714-425-5046
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JACK CHEN
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Credential | P.T.
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Telephone | 714-425-5046
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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 | 29842
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License Number State | CA
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