Provider Demographics
NPI:1295109007
Name:MOVEMENT RX PHYSICAL THERAPY, P.C.
Entity type:Organization
Organization Name:MOVEMENT RX PHYSICAL THERAPY, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PER
Authorized Official - Middle Name:
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-854-1343
Mailing Address - Street 1:3027 OLIVE ST
Mailing Address - Street 2:STREET
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-5002
Mailing Address - Country:US
Mailing Address - Phone:877-854-1343
Mailing Address - Fax:877-854-1343
Practice Address - Street 1:3146 TIGER RUN CT
Practice Address - Street 2:#120
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92010-6695
Practice Address - Country:US
Practice Address - Phone:877-854-1343
Practice Address - Fax:877-854-1343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-17
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy