Provider Demographics
NPI:1760848717
Name:IN MOTION PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:IN MOTION PHYSICAL THERAPY, LLC
Other - Org Name:IN MOTION PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCIALLA GRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:617-968-3999
Mailing Address - Street 1:40 BOLTON RD
Mailing Address - Street 2:
Mailing Address - City:NEWTONVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02460-2129
Mailing Address - Country:US
Mailing Address - Phone:617-968-3999
Mailing Address - Fax:
Practice Address - Street 1:40 BOLTON RD
Practice Address - Street 2:
Practice Address - City:NEWTONVILLE
Practice Address - State:MA
Practice Address - Zip Code:02460-2129
Practice Address - Country:US
Practice Address - Phone:617-968-3999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13393261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy