Provider Demographics
NPI:1801522768
Name:MOVEMENT PHYSICAL THERAPY AND SPINE
Entity type:Organization
Organization Name:MOVEMENT PHYSICAL THERAPY AND SPINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DALLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CERT MDT
Authorized Official - Phone:704-956-3361
Mailing Address - Street 1:13420 REESE BLVD W OFC 37
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-7925
Mailing Address - Country:US
Mailing Address - Phone:704-659-1917
Mailing Address - Fax:
Practice Address - Street 1:13420 REESE BLVD W OFC 37
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-7925
Practice Address - Country:US
Practice Address - Phone:704-659-1917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy