Provider Demographics
NPI:1811776842
Name:MVMTOLOGY LLC
Entity type:Organization
Organization Name:MVMTOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PASTUSZAK
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, PCES
Authorized Official - Phone:617-733-6273
Mailing Address - Street 1:85 ANTRIM ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-1103
Mailing Address - Country:US
Mailing Address - Phone:617-733-6273
Mailing Address - Fax:
Practice Address - Street 1:318 HARVARD ST STE 30
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-2912
Practice Address - Country:US
Practice Address - Phone:617-651-1587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty