Organization
MOVEMENT PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT WACKER PT, DPT, CSCS (OWNER)
(970) 217-8018
Entity
Organization
Contact information
Practice address
216 MAIN ST UNIT C-104, EDWARDS, CO 81632-8127
(970) 926-0767
Mailing address
PO BOX 1784, AVON, CO 81620-1784
(970) 926-0767
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
8600
CO
Other
Enumeration date
12/01/2010
Last updated
07/07/2011
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