Basic Information
| Provider Information | |||||||||
| NPI: | 1578776936 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | IN MOTION THERAPY, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3125 E SUPERIOR ST | ||||||||
| Address2: | |||||||||
| City: | DULUTH | ||||||||
| State: | MN | ||||||||
| PostalCode: | 558122356 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2183908788 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2711 W SUPERIOR ST | ||||||||
| Address2: | SUITE 209 | ||||||||
| City: | DULUTH | ||||||||
| State: | MN | ||||||||
| PostalCode: | 558061810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2187271180 | ||||||||
| FaxNumber: | 2187271461 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2007 | ||||||||
| LastUpdateDate: | 06/10/2008 | ||||||||
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| AuthorizedOfficialLastName: | WINKELS | ||||||||
| AuthorizedOfficialFirstName: | ANNITA | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICAL THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 2187271180 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | MPT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | 6659 | MN | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.