Provider Demographics
NPI:1740686922
Name:MOTIONLIFE CHIROPRACTIC & ACUPUNCTURE, LLC
Entity type:Organization
Organization Name:MOTIONLIFE CHIROPRACTIC & ACUPUNCTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANG
Authorized Official - Middle Name:MIN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC
Authorized Official - Phone:410-997-0987
Mailing Address - Street 1:8808 CENTRE PARK DR STE 208
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2221
Mailing Address - Country:US
Mailing Address - Phone:410-997-0987
Mailing Address - Fax:410-997-1250
Practice Address - Street 1:8808 CENTRE PARK DR STE 208
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2221
Practice Address - Country:US
Practice Address - Phone:410-997-0987
Practice Address - Fax:410-715-2280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-14
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03614111N00000X
MDU02139171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty