# ENLIVEN MOVEMENT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922622067
- **Authorized official:** KERRI ANN WAEGELEIN PT, DPT, OCS (PRESIDENT)
- **Authorized official phone:** (845) 242-8732

## Contact information

- **Practice address:** 1316 RUTLEDGE AVE STE 108, CHARLESTON, SC 29403-3050
- **Practice address phone:** (845) 242-8732
- **Mailing address:** 1316 RUTLEDGE AVE STE 108, CHARLESTON, SC 29403-3050
- **Mailing address phone:** (845) 242-8732

## Taxonomy

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

## Other

- **Enumeration date:** 06/04/2020
- **Last updated:** 10/28/2024