Provider Demographics
NPI:1841061025
Name:MAX MOVES PEDIATRIC PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:MAX MOVES PEDIATRIC PHYSICAL THERAPY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PT
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WINKELEER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:845-754-1148
Mailing Address - Street 1:1185 E 26TH PL
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-2927
Mailing Address - Country:US
Mailing Address - Phone:845-754-1148
Mailing Address - Fax:
Practice Address - Street 1:1185 E 26TH PL
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-2927
Practice Address - Country:US
Practice Address - Phone:845-754-1148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-16
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy