Provider Demographics
NPI:1508621483
Name:LIFEMOTION WORKS LLC
Entity Type:Organization
Organization Name:LIFEMOTION WORKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOODLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-267-1184
Mailing Address - Street 1:22 HATFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:NY
Mailing Address - Zip Code:13838-1333
Mailing Address - Country:US
Mailing Address - Phone:607-267-1184
Mailing Address - Fax:
Practice Address - Street 1:22 HATFIELD AVE
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NY
Practice Address - Zip Code:13838-1333
Practice Address - Country:US
Practice Address - Phone:607-267-1184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy