Provider Demographics
NPI:1255860433
Name:LIFE IN MOTION PHYSICAL & HAND THERAPY
Entity Type:Organization
Organization Name:LIFE IN MOTION PHYSICAL & HAND THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:D
Authorized Official - Last Name:RIVEROS
Authorized Official - Suffix:
Authorized Official - Credentials:MOTR/L
Authorized Official - Phone:727-369-6355
Mailing Address - Street 1:9125 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-5406
Mailing Address - Country:US
Mailing Address - Phone:727-369-6355
Mailing Address - Fax:727-362-4766
Practice Address - Street 1:9021 OAKHURST RD STE A
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33776-2156
Practice Address - Country:US
Practice Address - Phone:727-369-6355
Practice Address - Fax:727-362-4766
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFE IN MOTION PHYSICAL & HAND THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-09
Last Update Date:2017-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty