Provider Demographics
NPI:1831553403
Name:MOTION IS LIFE CHIROPRACTIC
Entity type:Organization
Organization Name:MOTION IS LIFE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:850-797-8144
Mailing Address - Street 1:863 SOLIMAR WAY
Mailing Address - Street 2:
Mailing Address - City:MARY ESTHER
Mailing Address - State:FL
Mailing Address - Zip Code:32569-1421
Mailing Address - Country:US
Mailing Address - Phone:850-797-8144
Mailing Address - Fax:
Practice Address - Street 1:4476 LEGENDARY DR
Practice Address - Street 2:SUITE 202
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-5375
Practice Address - Country:US
Practice Address - Phone:850-974-4842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-11
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 11812111NN1001X, 111NR0400X, 111NX0800X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
No111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty