Provider Demographics
NPI:1821865767
Name:THE MOVEMENT PARADIGM
Entity Type:Organization
Organization Name:THE MOVEMENT PARADIGM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FUNCT'L MEDICINE PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MISSIMER
Authorized Official - Suffix:
Authorized Official - Credentials:IFMCP, PT, LDN, RD
Authorized Official - Phone:302-635-9220
Mailing Address - Street 1:101 MANOR AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-2601
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 MANOR AVE
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-2601
Practice Address - Country:US
Practice Address - Phone:302-635-9220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service