MEDICARE: BODY IN MOTION PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	109835	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	R54D257	OTHER	MO	IND #

General Provider Information

NPI Number	:	1740275502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BODY IN MOTION PC

Provider Business Mailing Address
First Line	:	5700 N POLK DR
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64151-2696
Country	:	US
Telephone Number	:	816-587-1228
Fax Number	:

Provider Business Practice Location Address
First Line	:	4901 MAIN ST
Second Line	:	STE 308
City	:	KANSAS CITY
State	:	MO
Zip	:	64112-2646
Country	:	US
Telephone Number	:	816-960-4788
Fax Number	:	816-753-1119

Authorized Official
Title or Position	:	OWNER
Name	:	SUSHMA S PATEL
Credential	:	PT
Telephone Number	:	816-960-4788

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	08/17/2007

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Directions to “BODY IN MOTION PC ” Practice Location

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