Provider Demographics
NPI:1184670804
Name:IMPT, INC.
Entity Type:Organization
Organization Name:IMPT, INC.
Other - Org Name:IN MOTION PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGING DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:ANTOUN
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, MPT
Authorized Official - Phone:949-861-8600
Mailing Address - Street 1:17332 VON KARMAN AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6242
Mailing Address - Country:US
Mailing Address - Phone:949-861-8600
Mailing Address - Fax:949-861-8601
Practice Address - Street 1:17332 VON KARMAN AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6242
Practice Address - Country:US
Practice Address - Phone:949-861-8600
Practice Address - Fax:949-861-8601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW17857Medicare ID - Type Unspecified