Provider Demographics
NPI:1093575912
Name:MOVEMENT CUBE LLC
Entity Type:Organization
Organization Name:MOVEMENT CUBE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:DWAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLBEK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-416-7238
Mailing Address - Street 1:1755 N HIGHWAY 66 STE F
Mailing Address - Street 2:
Mailing Address - City:CATOOSA
Mailing Address - State:OK
Mailing Address - Zip Code:74015-2717
Mailing Address - Country:US
Mailing Address - Phone:918-416-7238
Mailing Address - Fax:
Practice Address - Street 1:1755 N HIGHWAY 66 STE F
Practice Address - Street 2:
Practice Address - City:CATOOSA
Practice Address - State:OK
Practice Address - Zip Code:74015-2717
Practice Address - Country:US
Practice Address - Phone:918-416-7238
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty