Healthcare Provider Details

I. General information

NPI: 1801435334
Provider Name (Legal Business Name): INMOTION REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/01/2020
Last Update Date: 01/01/2020
Certification Date: 01/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5140 GALAXIE DR
JACKSON MS
39206-4335
US

IV. Provider business mailing address

PO BOX 75
MADISON MS
39130-0075
US

V. Phone/Fax

Practice location:
  • Phone: 769-216-3288
  • Fax:
Mailing address:
  • Phone: 601-940-5906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name: RICHARD THOMAS ELDRIDGE
Title or Position: LPTA
Credential:
Phone: 601-906-3270