Basic Information
| Provider Information | |||||||||
| NPI: | 1770158719 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MOVEMENT MATTERS P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16950 PINE OAKS DR | ||||||||
| Address2: | |||||||||
| City: | REDDING | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960031033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5303554687 | ||||||||
| FaxNumber: | 5302223657 | ||||||||
| Practice Location | |||||||||
| Address1: | 2895 CHURN CREEK RD STE D | ||||||||
| Address2: | |||||||||
| City: | REDDING | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960021158 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5302223622 | ||||||||
| FaxNumber: | 5302223657 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2021 | ||||||||
| LastUpdateDate: | 05/21/2021 | ||||||||
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| AuthorizedOfficialLastName: | JOHNSON | ||||||||
| AuthorizedOfficialFirstName: | LINDA | ||||||||
| AuthorizedOfficialMiddleName: | CHRISTINE | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5303554687 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | P.T. | ||||||||
| NPICertificationDate: | 05/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.