Provider Demographics
NPI:1659848919
Name:MOVEMENT SPECIALIST & MANUAL THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:MOVEMENT SPECIALIST & MANUAL THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:PAPCIAK
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:708-369-9811
Mailing Address - Street 1:20011 WHIE PINE CT
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448
Mailing Address - Country:US
Mailing Address - Phone:708-369-9811
Mailing Address - Fax:708-294-2516
Practice Address - Street 1:5059 W 111TH ST
Practice Address - Street 2:
Practice Address - City:ALSIP
Practice Address - State:IL
Practice Address - Zip Code:60803-6074
Practice Address - Country:US
Practice Address - Phone:708-369-9811
Practice Address - Fax:708-294-2516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1447425574OtherPERSONAL NPI