Provider Demographics
NPI:1376835108
Name:IN MOTION CHIROPRACTIC AND FITNESS CENTER
Entity Type:Organization
Organization Name:IN MOTION CHIROPRACTIC AND FITNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVITT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:763-694-1974
Mailing Address - Street 1:1161 WAYZATA BLVD E # 170
Mailing Address - Street 2:
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-1935
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1161 WAYZATA BLVD E # 170
Practice Address - Street 2:
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-1935
Practice Address - Country:US
Practice Address - Phone:763-694-1974
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3842273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit