Organization
MOVE2PERFORM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IAN JAMES STOUT DPT, ATC (DOCTOR OF PHYSICAL THERAPY)
(570) 259-7087
Entity
Organization
Contact information
Practice address
175 WELLES ST REAR, FORTY FORT, PA 18704-4933
(570) 310-1086
Mailing address
1915 ENGLEWOOD TER, FORTY FORT, PA 18704-4321
(570) 259-7087
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/03/2023
Last updated
10/03/2023
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