Provider Demographics
NPI:1659919249
Name:MOVEMENT CHIROPRACTIC AND MASSAGE, LLC
Entity Type:Organization
Organization Name:MOVEMENT CHIROPRACTIC AND MASSAGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:THAANUM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-820-7746
Mailing Address - Street 1:603 HUNT AVE
Mailing Address - Street 2:
Mailing Address - City:SUMNER
Mailing Address - State:WA
Mailing Address - Zip Code:98390-1117
Mailing Address - Country:US
Mailing Address - Phone:253-863-0855
Mailing Address - Fax:
Practice Address - Street 1:603 HUNT AVE
Practice Address - Street 2:
Practice Address - City:SUMNER
Practice Address - State:WA
Practice Address - Zip Code:98390-1117
Practice Address - Country:US
Practice Address - Phone:253-863-0855
Practice Address - Fax:253-826-0511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-14
Last Update Date:2019-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NP0017XChiropractic ProvidersChiropractorPediatric ChiropractorGroup - Multi-Specialty
No111NR0200XChiropractic ProvidersChiropractorRadiologyGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty