Provider Demographics
NPI:1184392128
Name:MOVEMENT CHIROPRACTIC & WELLNESS, PLLC
Entity type:Organization
Organization Name:MOVEMENT CHIROPRACTIC & WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:763-898-3517
Mailing Address - Street 1:7373 KIRKWOOD CT N STE 110
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-5211
Mailing Address - Country:US
Mailing Address - Phone:763-898-3517
Mailing Address - Fax:763-205-0417
Practice Address - Street 1:7373 KIRKWOOD CT N STE 110
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-5211
Practice Address - Country:US
Practice Address - Phone:763-898-3517
Practice Address - Fax:763-205-0417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-03
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty