Provider Demographics
NPI:1114169257
Name:INMOTION PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:INMOTION PHYSICAL THERAPY LLC
Other - Org Name:INMOTION PHYSICAL THERAPY AND FITNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:CAREY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:218-855-0806
Mailing Address - Street 1:15860 AUDUBON WAY # 101
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-6942
Mailing Address - Country:US
Mailing Address - Phone:218-454-0088
Mailing Address - Fax:218-454-0086
Practice Address - Street 1:15860 AUDUBON WAY # 101
Practice Address - Street 2:
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-6942
Practice Address - Country:US
Practice Address - Phone:218-454-0088
Practice Address - Fax:218-454-0086
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INMOTION PHYSICAL THERAPY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7284261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN024944100Medicaid
MN024944100Medicaid