Provider Demographics
NPI:1821367640
Name:GUIDED MOTION, LLC
Entity Type:Organization
Organization Name:GUIDED MOTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANN
Authorized Official - Middle Name:ALLYN
Authorized Official - Last Name:JENNELLE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, LMT
Authorized Official - Phone:678-431-7096
Mailing Address - Street 1:125 W LAKE DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-1140
Mailing Address - Country:US
Mailing Address - Phone:678-431-7096
Mailing Address - Fax:678-348-7334
Practice Address - Street 1:102 RUSSELL RD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-1147
Practice Address - Country:US
Practice Address - Phone:678-431-7096
Practice Address - Fax:678-348-7334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-22
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT003325261Q00000X
GAPT008547261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center