Provider Demographics
NPI:1326503764
Name:ORTHOMOTION TECHNOLOGY INC
Entity Type:Organization
Organization Name:ORTHOMOTION TECHNOLOGY INC
Other - Org Name:FAMILY HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:E
Authorized Official - Last Name:MATHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-383-3156
Mailing Address - Street 1:505 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:IL
Mailing Address - Zip Code:60927-9433
Mailing Address - Country:US
Mailing Address - Phone:815-694-2619
Mailing Address - Fax:815-694-2022
Practice Address - Street 1:505 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:IL
Practice Address - Zip Code:60927-9433
Practice Address - Country:US
Practice Address - Phone:815-694-2619
Practice Address - Fax:815-694-2022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-08
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies