Provider Demographics
NPI:1457478588
Name:MOTION DYNAMICS PHYSICAL THERAPY
Entity Type:Organization
Organization Name:MOTION DYNAMICS PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:HOFFMANN
Authorized Official - Last Name:NOLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-277-6052
Mailing Address - Street 1:14248 HIGHWAY 1085
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-6906
Mailing Address - Country:US
Mailing Address - Phone:504-352-5602
Mailing Address - Fax:
Practice Address - Street 1:8101 W JUDGE PEREZ DR
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-1659
Practice Address - Country:US
Practice Address - Phone:504-277-6052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPT481261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5S567Medicare ID - Type Unspecified