Provider Demographics
NPI:1912091166
Name:INMOTION PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:INMOTION PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:CAREY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:218-855-0806
Mailing Address - Street 1:1927 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-4526
Mailing Address - Country:US
Mailing Address - Phone:218-855-0806
Mailing Address - Fax:218-855-0737
Practice Address - Street 1:1927 S 6TH ST
Practice Address - Street 2:
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-4526
Practice Address - Country:US
Practice Address - Phone:218-855-0806
Practice Address - Fax:218-855-0737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7284225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN024944100Medicaid
MNC03965Medicare ID - Type Unspecified