Provider Demographics
NPI:1619297470
Name:BRING MOTION BACK, INC.
Entity Type:Organization
Organization Name:BRING MOTION BACK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/LPT
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:W
Authorized Official - Last Name:BAUDENDISTEL
Authorized Official - Suffix:
Authorized Official - Credentials:LPT
Authorized Official - Phone:360-970-4817
Mailing Address - Street 1:PO BOX 11128
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98508-1128
Mailing Address - Country:US
Mailing Address - Phone:360-970-4817
Mailing Address - Fax:
Practice Address - Street 1:8650 MARTIN WAY E
Practice Address - Street 2:SUITE #1
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98516-6610
Practice Address - Country:US
Practice Address - Phone:360-970-4817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009567225100000X
WAOT00001630225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty