Provider Demographics
NPI:1346780392
Name:MOVEUP PLLC
Entity Type:Organization
Organization Name:MOVEUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:RENFRO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:918-440-1619
Mailing Address - Street 1:6024 CORNELL DR
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-8929
Mailing Address - Country:US
Mailing Address - Phone:918-440-1619
Mailing Address - Fax:918-876-6545
Practice Address - Street 1:5204 JACQUELYN LN
Practice Address - Street 2:SUITE 12
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-7733
Practice Address - Country:US
Practice Address - Phone:918-440-1619
Practice Address - Fax:918-876-6545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-24
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy