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General NPI Number Information
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NPI Number | 1467559740
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Entity Type | Organization
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Legal Business Name | KIDS IN MOTION PEDIATRIC THERAPY SERVICES LTD.
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/24/2012
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Provider Practice Location Address
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Address Line | 2636 S MILFORD RD
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City | HIGHLAND
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State | MI
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Zip | 48357-4938
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Country | US
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Telephone | 248-684-9610
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Fax | 248-684-9611
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Provider Business Mailing Address
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Address Line | 2636 S MILFORD RD
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City | HIGHLAND
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State | MI
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Zip | 48357-4938
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Country | US
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Telephone | 248-684-9610
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Fax | 248-684-9611
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. MARY THERESE HYDORN
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Credential | PT
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Telephone | 248-684-9610
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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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