Provider Demographics
NPI:1457570509
Name:INDUSTRIAL ATHLETES IN MOTION
Entity Type:Organization
Organization Name:INDUSTRIAL ATHLETES IN MOTION
Other - Org Name:I-AIM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNTING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PIECHOCKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-954-0950
Mailing Address - Street 1:5060 CASCADE RD SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-3808
Mailing Address - Country:US
Mailing Address - Phone:616-954-0950
Mailing Address - Fax:616-954-1728
Practice Address - Street 1:5060 CASCADE RD SE
Practice Address - Street 2:SUITE A
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-3808
Practice Address - Country:US
Practice Address - Phone:616-954-0950
Practice Address - Fax:616-954-1728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy