Provider Demographics
NPI:1689174922
Name:MOTUS CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:MOTUS CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAASS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-494-0165
Mailing Address - Street 1:1612 GARTH BROOKS BLVD
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-7441
Mailing Address - Country:US
Mailing Address - Phone:405-494-0165
Mailing Address - Fax:405-832-1136
Practice Address - Street 1:1612 GARTH BROOKS BLVD
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-7441
Practice Address - Country:US
Practice Address - Phone:405-494-0165
Practice Address - Fax:405-832-1136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4269111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty