Provider Demographics
NPI:1609080647
Name:MOTION FOR LIFE LLC
Entity Type:Organization
Organization Name:MOTION FOR LIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:COVELL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:260-829-6363
Mailing Address - Street 1:6995N 750 W
Mailing Address - Street 2:
Mailing Address - City:ORLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46776
Mailing Address - Country:US
Mailing Address - Phone:484-888-5544
Mailing Address - Fax:
Practice Address - Street 1:6995N 750 W
Practice Address - Street 2:
Practice Address - City:ORLAND
Practice Address - State:IN
Practice Address - Zip Code:46776
Practice Address - Country:US
Practice Address - Phone:260-829-6363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05005005A261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy