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General NPI Number Information
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NPI Number | 1366030769
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Entity Type | Organization
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Legal Business Name | ADVANCED IN MOTION LLC
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Dates
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Enumeration Date | 01/02/2021
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Last Update Date | 01/02/2021
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Provider Practice Location Address
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Address Line | 302 SPANISH OAK DR
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City | BARDSTOWN
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State | KY
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Zip | 40004-3271
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Country | US
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Telephone | 502-510-0003
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Fax |
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Provider Business Mailing Address
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Address Line | 302 SPANISH OAK DR
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City | BARDSTOWN
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State | KY
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Zip | 40004-3271
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Country | US
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Telephone | 502-510-0003
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | ANGELA TAYLOR
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Credential | OTR/L
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Telephone | 502-510-0003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number |
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License Number State |
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