Provider Demographics
NPI:1891018982
Name:FREE MOTION PHYSICAL THERAPY
Entity Type:Organization
Organization Name:FREE MOTION PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:D
Authorized Official - Last Name:VIGH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:540-344-2116
Mailing Address - Street 1:3308 FRANKLIN RD SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-1310
Mailing Address - Country:US
Mailing Address - Phone:540-344-2116
Mailing Address - Fax:540-344-2118
Practice Address - Street 1:3308 FRANKLIN RD SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-1310
Practice Address - Country:US
Practice Address - Phone:540-344-2116
Practice Address - Fax:540-344-2118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305205390174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty