Provider Demographics
NPI:1013920719
Name:IN MOTION PHYSICAL THERAPY & REHABILITATION P C
Entity Type:Organization
Organization Name:IN MOTION PHYSICAL THERAPY & REHABILITATION P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BROCK
Authorized Official - Middle Name:R
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:610-518-9100
Mailing Address - Street 1:20 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-3058
Mailing Address - Country:US
Mailing Address - Phone:610-518-9100
Mailing Address - Fax:610-518-0992
Practice Address - Street 1:20 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-3058
Practice Address - Country:US
Practice Address - Phone:610-518-9100
Practice Address - Fax:610-518-0992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2000X
PA6000007366332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007548800004Medicaid
PA1007548800004Medicaid
PA048880Medicare ID - Type Unspecified