Provider Demographics
NPI:1154065027
Name:MVMT EVANSTON PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:MVMT EVANSTON PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHRISTAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-877-8930
Mailing Address - Street 1:604 DAVIS ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4543
Mailing Address - Country:US
Mailing Address - Phone:412-877-8930
Mailing Address - Fax:
Practice Address - Street 1:604 DAVIS ST
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4543
Practice Address - Country:US
Practice Address - Phone:412-877-8930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty