Provider Demographics
NPI:1912549189
Name:THE MVMT INSTITUTE
Entity Type:Organization
Organization Name:THE MVMT INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:P
Authorized Official - Last Name:LANNAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS
Authorized Official - Phone:812-903-0001
Mailing Address - Street 1:3620 PAOLI PIKE STE 1
Mailing Address - Street 2:
Mailing Address - City:FLOYDS KNOBS
Mailing Address - State:IN
Mailing Address - Zip Code:47119-9787
Mailing Address - Country:US
Mailing Address - Phone:812-903-0001
Mailing Address - Fax:812-903-0097
Practice Address - Street 1:3620 PAOLI PIKE STE 1
Practice Address - Street 2:
Practice Address - City:FLOYDS KNOBS
Practice Address - State:IN
Practice Address - Zip Code:47119-9787
Practice Address - Country:US
Practice Address - Phone:812-903-0001
Practice Address - Fax:812-903-0097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-09
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty