Healthcare Provider Details
I. General information
NPI: 1437435658
Provider Name (Legal Business Name): INMOTION HEALTH & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/02/2011
Last Update Date: 01/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4425 E AGAVE RD SUITE 150
PHOENIX AZ
85044-0619
US
IV. Provider business mailing address
4425 E AGAVE RD SUITE 150
PHOENIX AZ
85044-0619
US
V. Phone/Fax
- Phone: 602-400-5967
- Fax: 866-467-4430
- Phone: 602-400-5967
- Fax: 866-467-4430
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 7575 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | MT-13327 |
| License Number State | AZ |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RS0012X |
| Taxonomy | Sleep Medicine (Internal Medicine) Physician |
| License Number | 6149394-1205 |
| License Number State | UT |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 8224 |
| License Number State | AZ |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 8468 |
| License Number State | AZ |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 8422 |
| License Number State | AZ |
VIII. Authorized Official
Name: MRS.
HEATHER
JEAN
BENINATO
Title or Position: CEO/OWNER
Credential: LMT
Phone: 602-400-5967