Provider Demographics
NPI:1528363934
Name:MOVE WELL
Entity Type:Organization
Organization Name:MOVE WELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JACOB
Authorized Official - Last Name:BOYCE
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:301-221-8863
Mailing Address - Street 1:315 PHILADELPHIA AVE
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-4201
Mailing Address - Country:US
Mailing Address - Phone:301-221-8863
Mailing Address - Fax:
Practice Address - Street 1:315 PHILADELPHIA AVE
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-4201
Practice Address - Country:US
Practice Address - Phone:301-221-8863
Practice Address - Fax:301-588-1025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-14
Last Update Date:2011-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21117225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty