Provider Demographics
NPI:1154969392
Name:PHYSIO IN MOTION - MOBILE PHYSICAL THERAPY AND WELLNESS
Entity type:Organization
Organization Name:PHYSIO IN MOTION - MOBILE PHYSICAL THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALCANTARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-716-1672
Mailing Address - Street 1:14510 SOURGUM RD
Mailing Address - Street 2:
Mailing Address - City:BOYDS
Mailing Address - State:MD
Mailing Address - Zip Code:20841-0110
Mailing Address - Country:US
Mailing Address - Phone:240-716-1672
Mailing Address - Fax:
Practice Address - Street 1:14510 SOURGUM RD
Practice Address - Street 2:
Practice Address - City:BOYDS
Practice Address - State:MD
Practice Address - Zip Code:20841-0110
Practice Address - Country:US
Practice Address - Phone:240-716-1672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-18
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy