Provider Demographics
NPI:1003370222
Name:MED-ART IN MOTION, LLC
Entity Type:Organization
Organization Name:MED-ART IN MOTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSIE
Authorized Official - Middle Name:THORNTON
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:ALC
Authorized Official - Phone:334-649-2966
Mailing Address - Street 1:4408 MCCAMPBELL DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-3524
Mailing Address - Country:US
Mailing Address - Phone:334-467-7084
Mailing Address - Fax:
Practice Address - Street 1:1720 W 3RD ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1506
Practice Address - Country:US
Practice Address - Phone:334-649-2966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty