Provider Demographics
NPI:1164606083
Name:MIND AND MOTION LLC
Entity Type:Organization
Organization Name:MIND AND MOTION LLC
Other - Org Name:MIND AND MOTION PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:HUMPHREYS
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS PT
Authorized Official - Phone:907-523-1110
Mailing Address - Street 1:431 N FRANKLIN ST STE 305
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-1186
Mailing Address - Country:US
Mailing Address - Phone:907-523-1110
Mailing Address - Fax:907-523-1136
Practice Address - Street 1:431 N FRANKLIN ST STE 305
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-1186
Practice Address - Country:US
Practice Address - Phone:907-523-1110
Practice Address - Fax:907-523-1136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK669225100000X
226300000X, 261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapistGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty