Provider Demographics
NPI:1902473952
Name:MOVE MORE PERFORMANCE - WELLNESS - REHAB
Entity Type:Organization
Organization Name:MOVE MORE PERFORMANCE - WELLNESS - REHAB
Other - Org Name:INTEGRATED REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WYATT
Authorized Official - Middle Name:
Authorized Official - Last Name:WITTY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:307-217-1067
Mailing Address - Street 1:1595 GRAND AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-3055
Mailing Address - Country:US
Mailing Address - Phone:307-217-1067
Mailing Address - Fax:406-534-3396
Practice Address - Street 1:1595 GRAND AVE STE 200
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3055
Practice Address - Country:US
Practice Address - Phone:307-217-1067
Practice Address - Fax:406-534-3396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy