Healthcare Provider Details

I. General information

NPI: 1164606083
Provider Name (Legal Business Name): MIND AND MOTION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 COLEMAN ST
JUNEAU AK
99801-1401
US

IV. Provider business mailing address

316 COLEMAN ST
JUNEAU AK
99801-1401
US

V. Phone/Fax

Practice location:
  • Phone: 907-523-1110
  • Fax: 907-782-4099
Mailing address:
  • Phone: 907-523-1110
  • Fax: 907-782-4099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number669
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code226300000X
TaxonomyKinesiotherapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MORGAN HUMPHREYS DAVIS
Title or Position: PHYSICAL THERAPIST/OWNER
Credential: MS PT
Phone: 907-523-1110