Provider Demographics
NPI:1881215085
Name:MOVE WELL AGE WELL, LLC
Entity Type:Organization
Organization Name:MOVE WELL AGE WELL, LLC
Other - Org Name:KEEP THE ADVENTURE ALIVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUHN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:989-284-8969
Mailing Address - Street 1:2693 E TEAL WAY
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84093-2823
Mailing Address - Country:US
Mailing Address - Phone:989-284-8969
Mailing Address - Fax:
Practice Address - Street 1:2223 S HIGHLAND DR STE E6-256
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-3672
Practice Address - Country:US
Practice Address - Phone:801-839-5592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-29
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy