Provider Demographics
NPI:1245844703
Name:MOVEMENT PHYSICAL AND OCCUPATIONAL THERAPY LLC
Entity type:Organization
Organization Name:MOVEMENT PHYSICAL AND OCCUPATIONAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:STREEFKERK
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:586-531-5825
Mailing Address - Street 1:14700 KING RD STE B
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:MI
Mailing Address - Zip Code:48193-7909
Mailing Address - Country:US
Mailing Address - Phone:586-531-5825
Mailing Address - Fax:
Practice Address - Street 1:14700 KING RD STE B
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:MI
Practice Address - Zip Code:48193-7909
Practice Address - Country:US
Practice Address - Phone:586-531-5825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-02
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty