Provider Demographics
NPI:1174098545
Name:MOVE AND GROW PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:MOVE AND GROW PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:GROZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-441-4831
Mailing Address - Street 1:621 BUFFALO RD
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-1140
Mailing Address - Country:US
Mailing Address - Phone:570-441-4831
Mailing Address - Fax:
Practice Address - Street 1:621 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-1140
Practice Address - Country:US
Practice Address - Phone:570-441-4831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty