Provider Demographics
NPI:1578614863
Name:MOTION PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:MOTION PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-514-3242
Mailing Address - Street 1:PO BOX 367
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:WI
Mailing Address - Zip Code:53167-0367
Mailing Address - Country:US
Mailing Address - Phone:262-514-3242
Mailing Address - Fax:
Practice Address - Street 1:1600 OHIO ST
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53405-3123
Practice Address - Country:US
Practice Address - Phone:262-331-4397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty