MEDICARE: MOVEMENT THEORY PHYSICAL THERAPY AND WELLNESS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1568114767
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOVEMENT THEORY PHYSICAL THERAPY AND WELLNESS PLLC

Provider Business Mailing Address
First Line	:	3736 VENICE DR
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-1536
Country	:	US
Telephone Number	:
Fax Number	:	877-887-2564

Provider Business Practice Location Address
First Line	:	6350 GLENVIEW DR STE 108
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-9584
Country	:	US
Telephone Number	:	817-907-7993
Fax Number	:	877-887-2564

Authorized Official
Title or Position	:	OWNER/LICENSED PHYSICAL THERAPIST
Name	:	JARRED TOBIN
Credential	:	DPT
Telephone Number	:	817-907-7993

Provider Enumeration Date	:	01/19/2022
Last Update Date	:	11/02/2023

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