Healthcare Provider Details

I. General information

NPI: 1043870264
Provider Name (Legal Business Name): MOTUS PHYSICAL THERAPY NW, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2019
Last Update Date: 06/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 NW 9TH ST
CORVALLIS OR
97330-1573
US

IV. Provider business mailing address

1110 NW 33RD ST
CORVALLIS OR
97330-4420
US

V. Phone/Fax

Practice location:
  • Phone: 443-812-1323
  • Fax:
Mailing address:
  • Phone: 443-812-1323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN LYNCH
Title or Position: PRESIDENT
Credential: DPT
Phone: 443-812-1323