Provider Demographics
NPI:1790512861
Name:VITAL MOVEMENT, LLC
Entity type:Organization
Organization Name:VITAL MOVEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KARA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:NORTON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:870-636-9202
Mailing Address - Street 1:1500 S CARAWAY RD STE B
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-5308
Mailing Address - Country:US
Mailing Address - Phone:870-530-9007
Mailing Address - Fax:870-698-8059
Practice Address - Street 1:1500 S CARAWAY RD STE B
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-5308
Practice Address - Country:US
Practice Address - Phone:870-530-9007
Practice Address - Fax:870-698-8059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-13
Last Update Date:2025-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty