Healthcare Provider Details

I. General information

NPI: 1679311385
Provider Name (Legal Business Name): BODY IN MOTION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2024
Last Update Date: 07/17/2024
Certification Date: 07/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 FLAGMAN WAY STE B1
SANTA FE NM
87505-1137
US

IV. Provider business mailing address

1221 FLAGMAN WAY STE B1
SANTA FE NM
87505-1137
US

V. Phone/Fax

Practice location:
  • Phone: 505-398-0458
  • Fax:
Mailing address:
  • Phone: 505-398-0458
  • 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: ROBERT SANCHEZ
Title or Position: OWNER
Credential: DC
Phone: 505-398-0458