=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508104118
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MOTION TECH SERVICES L.L.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/17/2013
-----------------------------------------------------
Last Update Date | 03/18/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2505 EAST PARIS AVE SE SUITE 125
-----------------------------------------------------
City | GRAND RAPIDS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49546-2459
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 616-706-4579
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2505 EAST PARIS AVE SE
-----------------------------------------------------
City | GRAND RAPIDS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49546-2459
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 616-706-4579
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MRS. KELLY HARTMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 616-706-4579
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------