Provider Demographics
NPI:1023489531
Name:MOVEMENT VALUED MANUAL THERAPY PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:MOVEMENT VALUED MANUAL THERAPY PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:M
Authorized Official - Last Name:LUSK
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:646-430-5717
Mailing Address - Street 1:35 W 35TH ST RM 301
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2249
Mailing Address - Country:US
Mailing Address - Phone:646-430-5717
Mailing Address - Fax:646-514-1972
Practice Address - Street 1:35 W 35TH ST RM 301
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2249
Practice Address - Country:US
Practice Address - Phone:646-430-5717
Practice Address - Fax:646-514-1972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-09
Last Update Date:2021-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0315692251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty