Provider Demographics
NPI:1679039432
Name:LETS MOVE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:LETS MOVE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:RABITO
Authorized Official - Suffix:
Authorized Official - Credentials:PT DPT
Authorized Official - Phone:847-239-2876
Mailing Address - Street 1:8545 LOG CABIN WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89143-1001
Mailing Address - Country:US
Mailing Address - Phone:702-620-3124
Mailing Address - Fax:702-938-5892
Practice Address - Street 1:8545 LOG CABIN WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89143-1001
Practice Address - Country:US
Practice Address - Phone:702-620-3124
Practice Address - Fax:702-938-5892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-18
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty