Provider Demographics
NPI:1922810969
Name:CLUB MOVE PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:CLUB MOVE PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:781-202-2065
Mailing Address - Street 1:43 WESTLAND AVE UNIT 507
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-4565
Mailing Address - Country:US
Mailing Address - Phone:781-202-2065
Mailing Address - Fax:866-570-1753
Practice Address - Street 1:23D CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-4601
Practice Address - Country:US
Practice Address - Phone:781-202-2065
Practice Address - Fax:866-570-1753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-27
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty