Provider Demographics
NPI:1649817206
Name:MOVE MOBILE THERAPY LLC
Entity type:Organization
Organization Name:MOVE MOBILE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:RENFRO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:405-815-9494
Mailing Address - Street 1:78 SUNBURST CT
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32081-0147
Mailing Address - Country:US
Mailing Address - Phone:405-815-9494
Mailing Address - Fax:
Practice Address - Street 1:78 SUNBURST CT
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA
Practice Address - State:FL
Practice Address - Zip Code:32081-0147
Practice Address - Country:US
Practice Address - Phone:405-815-9494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-03
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy