Provider Demographics
NPI:1881800894
Name:BODY IN MOTION
Entity type:Organization
Organization Name:BODY IN MOTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:PARCHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-681-5881
Mailing Address - Street 1:561 SHOAL CIR
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94065-2203
Mailing Address - Country:US
Mailing Address - Phone:510-681-5881
Mailing Address - Fax:
Practice Address - Street 1:561 SHOAL CIR
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94065-2203
Practice Address - Country:US
Practice Address - Phone:510-681-5881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA417642225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty