Provider Demographics
NPI:1417392804
Name:MOVEMENT MATTERS LLC
Entity Type:Organization
Organization Name:MOVEMENT MATTERS LLC
Other - Org Name:JIVA THERAPIES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZAROFF
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LMT
Authorized Official - Phone:303-880-4416
Mailing Address - Street 1:2375 S ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5538
Mailing Address - Country:US
Mailing Address - Phone:303-880-4416
Mailing Address - Fax:
Practice Address - Street 1:2375 S ADAMS ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5538
Practice Address - Country:US
Practice Address - Phone:303-880-4416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
COMT 13149225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty