Provider Demographics
NPI:1700524691
Name:VARIABLE MOVEMENT LLC
Entity Type:Organization
Organization Name:VARIABLE MOVEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:WATERMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DAT, LAT, ATC
Authorized Official - Phone:603-313-4227
Mailing Address - Street 1:15 UPLAND WAY
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-3475
Mailing Address - Country:US
Mailing Address - Phone:603-313-4227
Mailing Address - Fax:207-433-1465
Practice Address - Street 1:165 ELLSWORTH RD APT 3A
Practice Address - Street 2:
Practice Address - City:BLUE HILL
Practice Address - State:ME
Practice Address - Zip Code:04614-5423
Practice Address - Country:US
Practice Address - Phone:207-374-7228
Practice Address - Fax:207-433-1465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-22
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty