Organization
FUNCTIONAL MOVEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN GALLOWAY OTR/L (OWNER)
(757) 651-0183
Entity
Organization
Contact information
Practice address
124 STADIUM CT, PONTE VEDRA BEACH, FL 32082-3152
(757) 651-0183
Mailing address
124 STADIUM CT, PONTE VEDRA BEACH, FL 32082-3152
(757) 651-0183
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
10/15/2019
Last updated
10/15/2019
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