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General NPI Number Information
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NPI Number | 1225287006
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Entity Type | Organization
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Legal Business Name | MATTER IN MOTION PHYSICAL REHABILITATION, PA
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Dates
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Enumeration Date | 09/16/2008
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Last Update Date | 10/01/2008
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Provider Practice Location Address
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Address Line | 117 SOUTHBRIDGE ST
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City | SAN ANTONIO
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State | TX
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Zip | 78216-6229
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Country | US
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Telephone | 210-858-8500
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Fax | 210-599-8853
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Provider Business Mailing Address
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Address Line | 117 SOUTHBRIDGE ST
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City | SAN ANTONIO
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State | TX
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Zip | 78216-6229
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Country | US
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Telephone | 210-858-8500
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Fax | 210-599-8853
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. STEPHANIE PRADO
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Credential | M.D.
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Telephone | 210-858-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | K9153
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License Number State | TX
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