Provider Demographics
NPI:1740283449
Name:THERAPY IN MOTION PC
Entity type:Organization
Organization Name:THERAPY IN MOTION PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANNESLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-447-1991
Mailing Address - Street 1:2475 BOARDWALK
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6332
Mailing Address - Country:US
Mailing Address - Phone:405-447-1991
Mailing Address - Fax:405-447-1198
Practice Address - Street 1:2340 NW 32ND ST
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:OK
Practice Address - Zip Code:73065-6589
Practice Address - Country:US
Practice Address - Phone:405-392-3322
Practice Address - Fax:405-392-3356
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THERAPY IN MOTION PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-05-27
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK175206601OtherUS DEPARTMENT OF LABOR
OK200020850BMedicaid
OK200020850BMedicaid