Provider Demographics
NPI:1700607736
Name:MOTION BODYWORK, LLC
Entity type:Organization
Organization Name:MOTION BODYWORK, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CROCKETT
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:520-257-0530
Mailing Address - Street 1:2204 E 17TH ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-7001
Mailing Address - Country:US
Mailing Address - Phone:520-200-1621
Mailing Address - Fax:
Practice Address - Street 1:2030 E BROADWAY BLVD STE 15
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-5907
Practice Address - Country:US
Practice Address - Phone:520-257-0530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-22
Last Update Date:2024-12-24
Deactivation Date:2024-12-23
Deactivation Code:
Reactivation Date:2024-12-24
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty