Provider Demographics
NPI:1033879200
Name:FULL MOTION INTEGRATED MEDICINE, LLC
Entity Type:Organization
Organization Name:FULL MOTION INTEGRATED MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OLYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-651-2266
Mailing Address - Street 1:4815 1ST ST N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-2603
Mailing Address - Country:US
Mailing Address - Phone:757-651-2266
Mailing Address - Fax:
Practice Address - Street 1:4815 1ST ST N
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-2603
Practice Address - Country:US
Practice Address - Phone:757-651-2266
Practice Address - Fax:703-536-5902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-29
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty