Provider Demographics
NPI:1932573805
Name:CREATED FOR MOTION WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:CREATED FOR MOTION WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:KAY MORGAN
Authorized Official - Last Name:RICKELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:217-214-2692
Mailing Address - Street 1:105 N 36TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301-3704
Mailing Address - Country:US
Mailing Address - Phone:217-214-2692
Mailing Address - Fax:
Practice Address - Street 1:105 N 36TH ST STE 101
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-3704
Practice Address - Country:US
Practice Address - Phone:217-214-2692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-16
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty