Provider Demographics
NPI:1265980569
Name:ORTHOMOTION INC.
Entity type:Organization
Organization Name:ORTHOMOTION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTRON
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:305-505-5596
Mailing Address - Street 1:1240 PINE ST
Mailing Address - Street 2:SUITE 113
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-4809
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1240 PINE ST
Practice Address - Street 2:SUITE 113
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-4809
Practice Address - Country:US
Practice Address - Phone:305-505-5596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT0003373261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO12439919OtherCAQH