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General NPI Number Information
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NPI Number | 1922975580
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Entity Type | Organization
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Legal Business Name | OPTIMAL MOVEMENT INSTITUTE LLC
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Dates
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Enumeration Date | 10/20/2025
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 12292 HANCOCK ST
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City | CARMEL
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State | IN
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Zip | 46032-5805
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Country | US
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Telephone | 317-727-0113
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Fax | 317-973-8121
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Provider Business Mailing Address
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Address Line | 12672 LIMBERLOST DR
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City | CARMEL
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State | IN
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Zip | 46033-9792
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Country | US
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Telephone | 317-727-0113
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Fax | 317-973-8121
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | MATTHEQ BASHORE
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Credential |
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Telephone | 317-727-0113
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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 |
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License Number State |
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