Provider Demographics
NPI:1043838618
Name:MOVING FORWARD PHYSICAL THERAPY
Entity Type:Organization
Organization Name:MOVING FORWARD PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:RILKE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:GREENMUN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:518-232-7119
Mailing Address - Street 1:280 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:VT
Mailing Address - Zip Code:05655-9206
Mailing Address - Country:US
Mailing Address - Phone:518-232-7119
Mailing Address - Fax:
Practice Address - Street 1:56 OLD FARM RD
Practice Address - Street 2:
Practice Address - City:STOWE
Practice Address - State:VT
Practice Address - Zip Code:05672-4434
Practice Address - Country:US
Practice Address - Phone:802-633-0983
Practice Address - Fax:802-348-2497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty