Provider Demographics
NPI:1003819715
Name:THERAPY IN MOTION PC
Entity Type:Organization
Organization Name:THERAPY IN MOTION PC
Other - Org Name:THERAPY IN MOTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANNESLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-447-1991
Mailing Address - Street 1:2475 BOARDWALK ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6332
Mailing Address - Country:US
Mailing Address - Phone:405-447-1991
Mailing Address - Fax:405-447-1198
Practice Address - Street 1:2475 BOARDWALK
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6332
Practice Address - Country:US
Practice Address - Phone:405-447-1991
Practice Address - Fax:405-447-1198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200020850AMedicaid
OK175206600OtherUS DEPARTMENT OF LABOR
OK=========Medicare Oscar/Certification
OK175206600OtherUS DEPARTMENT OF LABOR
OK4583866OtherAETNA