Provider Demographics
NPI:1598232597
Name:MOTIO FOOT AND ANKLE SPECIALISTS PLLC
Entity Type:Organization
Organization Name:MOTIO FOOT AND ANKLE SPECIALISTS PLLC
Other - Org Name:MOTIO FOOT AND ANKLE SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAESER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:407-280-6039
Mailing Address - Street 1:5844 RED BUG LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5011
Mailing Address - Country:US
Mailing Address - Phone:321-765-9965
Mailing Address - Fax:
Practice Address - Street 1:5844 RED BUG LAKE RD
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-5011
Practice Address - Country:US
Practice Address - Phone:321-765-9965
Practice Address - Fax:321-765-3580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-28
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty