Organization
ENLIVEN MOVEMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRI ANN WAEGELEIN PT, DPT, OCS (PRESIDENT)
(845) 242-8732
Entity
Organization
Contact information
Practice address
1316 RUTLEDGE AVE STE 108, CHARLESTON, SC 29403-3050
(845) 242-8732
Mailing address
1316 RUTLEDGE AVE STE 108, CHARLESTON, SC 29403-3050
(845) 242-8732
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
06/04/2020
Last updated
10/28/2024
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