Provider Demographics
NPI:1972861417
Name:IN MOTION THERAPY, INC
Entity type:Organization
Organization Name:IN MOTION THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MADISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-727-1180
Mailing Address - Street 1:2701 W SUPERIOR ST
Mailing Address - Street 2:STE 112
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55806-1856
Mailing Address - Country:US
Mailing Address - Phone:218-727-1180
Mailing Address - Fax:218-727-1461
Practice Address - Street 1:2701 W SUPERIOR ST
Practice Address - Street 2:STE 112
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55806-1856
Practice Address - Country:US
Practice Address - Phone:218-727-1180
Practice Address - Fax:218-727-1461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy