Provider Demographics
NPI:1023563343
Name:THE MOVEMENT CHIROPRACTIC & PHYSICAL MEDICINE
Entity Type:Organization
Organization Name:THE MOVEMENT CHIROPRACTIC & PHYSICAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER AND DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GARET
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:760-983-9978
Mailing Address - Street 1:1340 TUSKAWILLA RD STE 112
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5030
Mailing Address - Country:US
Mailing Address - Phone:704-695-4800
Mailing Address - Fax:704-695-7887
Practice Address - Street 1:1340 TUSKAWILLA RD STE 112
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-5030
Practice Address - Country:US
Practice Address - Phone:704-695-4800
Practice Address - Fax:704-695-7887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11906111N00000X
FLCH11913111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty