Provider Demographics
NPI:1235605874
Name:MOVEMENT CLINIC, LLC
Entity type:Organization
Organization Name:MOVEMENT CLINIC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JESS
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:BROWER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-254-2203
Mailing Address - Street 1:1047 N STATE ROAD 57
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47501-7561
Mailing Address - Country:US
Mailing Address - Phone:812-254-2203
Mailing Address - Fax:812-254-2033
Practice Address - Street 1:102 E VAN TREES ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IN
Practice Address - Zip Code:47501-2943
Practice Address - Country:US
Practice Address - Phone:812-254-2203
Practice Address - Fax:812-254-2033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-22
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty