Healthcare Provider Details
I. General information
NPI: 1376801225
Provider Name (Legal Business Name): INMOTION CENTER, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/30/2012
Last Update Date: 02/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4301 N MACARTHUR BLVD SUITE 103
IRVING TX
75038-6497
US
IV. Provider business mailing address
4301 N MACARTHUR BLVD SUITE 103
IRVING TX
75038-6497
US
V. Phone/Fax
- Phone: 972-255-5588
- Fax: 972-255-6688
- Phone: 972-255-5588
- Fax: 972-255-6688
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DOUGLAS
S
WON
Title or Position: OWNER
Credential: MD
Phone: 972-255-5588