Provider Demographics
NPI:1801391354
Name:GREAT MOVEMENTS, LLC
Entity Type:Organization
Organization Name:GREAT MOVEMENTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRAGE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR
Authorized Official - Phone:317-250-0997
Mailing Address - Street 1:1013 35TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-1214
Mailing Address - Country:US
Mailing Address - Phone:317-250-0997
Mailing Address - Fax:
Practice Address - Street 1:1013 35TH AVE NE
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-1214
Practice Address - Country:US
Practice Address - Phone:317-250-0997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-27
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTOTP-OT-LIC-4690225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
14149457OtherCAQH ID