# MOVING MOUNTAINS THERAPY AT HOME LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Moving Mountains Therapy at Home, Moving Mountains Therapy at Home LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780224196
- **Authorized official:** DR. DONIEL M HAGEE DPT, OCS, ATC (DOCTOR OF PHYSICAL THERAPY)
- **Authorized official phone:** (360) 306-1383

## Contact information

- **Practice address:** 20469 JACKLIGHT LN, BEND, OR 97702-3074
- **Practice address phone:** (360) 306-1383
- **Practice address fax:** (541) 316-6526
- **Mailing address:** PO BOX 783, BEND, OR 97709-0783
- **Mailing address phone:** (541) 316-6520

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 01/14/2020
- **Last updated:** 02/19/2020