Provider Demographics
NPI:1760222756
Name:EMPOWERED MOVEMENT COMPANY LLC
Entity type:Organization
Organization Name:EMPOWERED MOVEMENT COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KARI
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:678-591-2773
Mailing Address - Street 1:5100 SOUTHLAND DR
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-6223
Mailing Address - Country:US
Mailing Address - Phone:574-904-0404
Mailing Address - Fax:
Practice Address - Street 1:5100 SOUTHLAND DR
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-6223
Practice Address - Country:US
Practice Address - Phone:574-904-0404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy