Healthcare Provider Details

I. General information

NPI: 1467395178
Provider Name (Legal Business Name): SALT & MOTION COLLECTIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2407 HARRIS AVE
KEY WEST FL
33040-3850
US

IV. Provider business mailing address

2407 HARRIS AVE
KEY WEST FL
33040-3850
US

V. Phone/Fax

Practice location:
  • Phone: 305-587-1702
  • Fax:
Mailing address:
  • Phone: 305-587-1702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MADISON DISSON
Title or Position: OWNER/LEAD PT
Credential: PT, DPT, OCS
Phone: 305-587-1702