Provider Demographics
NPI:1669907432
Name:HEALTH IN MOTION, LLC
Entity type:Organization
Organization Name:HEALTH IN MOTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:DODD
Authorized Official - Last Name:SELL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:203-803-8090
Mailing Address - Street 1:75 SASAPEQUAN RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-7205
Mailing Address - Country:US
Mailing Address - Phone:203-292-6063
Mailing Address - Fax:
Practice Address - Street 1:250 PEQUOT AVE
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:CT
Practice Address - Zip Code:06890-1387
Practice Address - Country:US
Practice Address - Phone:203-292-8722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-28
Last Update Date:2017-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007823261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy