Provider Demographics
NPI:1710916614
Name:HEALTH IN MOTION PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:HEALTH IN MOTION PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLET
Authorized Official - Suffix:
Authorized Official - Credentials:LPT
Authorized Official - Phone:406-585-4642
Mailing Address - Street 1:3985 VALLEY COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-6633
Mailing Address - Country:US
Mailing Address - Phone:406-585-4642
Mailing Address - Fax:406-585-2878
Practice Address - Street 1:3985 VALLEY COMMONS DR
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6633
Practice Address - Country:US
Practice Address - Phone:406-585-4642
Practice Address - Fax:406-585-2878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1203PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000083283Medicare ID - Type UnspecifiedGROUP ID NUMBER