Healthcare Provider Details

I. General information

NPI: 1831228006
Provider Name (Legal Business Name): ORTHOMOTION TECHNOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 E BETHEL DR
BOURBONNAIS IL
60914-1456
US

IV. Provider business mailing address

1100 HATCHER LN
COLUMBIA TN
38401-3530
US

V. Phone/Fax

Practice location:
  • Phone: 888-697-2210
  • Fax:
Mailing address:
  • Phone: 888-697-2210
  • Fax: 815-694-2022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number203.000878
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: DAVID R BAXTER
Title or Position: OWNER
Credential:
Phone: 931-375-1775