Provider Demographics
NPI:1740275502
Name:BODY IN MOTION PC
Entity type:Organization
Organization Name:BODY IN MOTION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSHMA
Authorized Official - Middle Name:S
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:816-960-4788
Mailing Address - Street 1:5700 N POLK DR
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-2696
Mailing Address - Country:US
Mailing Address - Phone:816-587-1228
Mailing Address - Fax:
Practice Address - Street 1:4901 MAIN ST
Practice Address - Street 2:STE 308
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64112-2646
Practice Address - Country:US
Practice Address - Phone:816-960-4788
Practice Address - Fax:816-753-1119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-16
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO109835225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOR54D257OtherIND #
MOR540000Medicare ID - Type UnspecifiedGR #