Provider Demographics
NPI:1073860144
Name:PAIN & MOVEMENT SOLUTIONS, LLC
Entity Type:Organization
Organization Name:PAIN & MOVEMENT SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:WINGEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:605-480-5149
Mailing Address - Street 1:511 NATIONAL ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BELLE FOURCHE
Mailing Address - State:SD
Mailing Address - Zip Code:57717-1836
Mailing Address - Country:US
Mailing Address - Phone:605-723-0185
Mailing Address - Fax:605-723-0186
Practice Address - Street 1:511 NATIONAL ST
Practice Address - Street 2:SUITE 101
Practice Address - City:BELLE FOURCHE
Practice Address - State:SD
Practice Address - Zip Code:57717-1836
Practice Address - Country:US
Practice Address - Phone:605-723-0185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-08
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1556225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty