Provider Demographics
NPI:1801653118
Name:LIFE IN MOTION HEALTH AND WELLNESS
Entity type:Organization
Organization Name:LIFE IN MOTION HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HAILEY
Authorized Official - Middle Name:
Authorized Official - Last Name:VANNOY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:251-979-0530
Mailing Address - Street 1:4650 WILDE LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32526-8755
Mailing Address - Country:US
Mailing Address - Phone:251-979-0530
Mailing Address - Fax:
Practice Address - Street 1:4650 WILDE LAKE BLVD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32526-8755
Practice Address - Country:US
Practice Address - Phone:251-979-0530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy