Provider Demographics
NPI: | 1942771068 |
---|---|
Name: | KIDS IN MOTION LLC |
Entity Type: | Organization |
Organization Name: | KIDS IN MOTION LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MEMBER/ OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JAMIE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HOFFMAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MS, OTR/L |
Authorized Official - Phone: | 603-882-4500 |
Mailing Address - Street 1: | 20 INDUSTRIAL PARK DR |
Mailing Address - Street 2: | |
Mailing Address - City: | NASHUA |
Mailing Address - State: | NH |
Mailing Address - Zip Code: | 03062-3178 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 603-882-4500 |
Mailing Address - Fax: | 603-882-4545 |
Practice Address - Street 1: | 20 INDUSTRIAL PARK DR |
Practice Address - Street 2: | |
Practice Address - City: | NASHUA |
Practice Address - State: | NH |
Practice Address - Zip Code: | 03062-3178 |
Practice Address - Country: | US |
Practice Address - Phone: | 603-882-4500 |
Practice Address - Fax: | 603-882-4545 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-12-16 |
Last Update Date: | 2018-12-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Single Specialty |