Provider Demographics
NPI:1710570403
Name:MOVEMENT CHIROPRACTIC
Entity Type:Organization
Organization Name:MOVEMENT CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:LIANNA
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:REPECKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-362-2586
Mailing Address - Street 1:1452 E LACKAWANNA ST
Mailing Address - Street 2:
Mailing Address - City:OLYPHANT
Mailing Address - State:PA
Mailing Address - Zip Code:18447-2151
Mailing Address - Country:US
Mailing Address - Phone:570-291-8397
Mailing Address - Fax:570-754-9768
Practice Address - Street 1:1452 E LACKAWANNA ST
Practice Address - Street 2:
Practice Address - City:OLYPHANT
Practice Address - State:PA
Practice Address - Zip Code:18447-2151
Practice Address - Country:US
Practice Address - Phone:570-291-8397
Practice Address - Fax:570-754-9768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-15
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty