Provider Demographics
NPI:1548673544
Name:THE MOVEMENT CLINIC LLC
Entity type:Organization
Organization Name:THE MOVEMENT CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JUTTA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRETTSCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:240-328-8415
Mailing Address - Street 1:3712 PERRY ST
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20722-1713
Mailing Address - Country:US
Mailing Address - Phone:240-328-8415
Mailing Address - Fax:
Practice Address - Street 1:7100 BALTIMORE AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-3627
Practice Address - Country:US
Practice Address - Phone:240-328-8415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-06
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty