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General NPI Number Information
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NPI Number | 1578130464
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Entity Type | Organization
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Legal Business Name | MARTIN IN MOTION THERAPY SERVICES LLC
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Dates
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Enumeration Date | 06/08/2021
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Last Update Date | 06/08/2021
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Provider Practice Location Address
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Address Line | 2099 SW AUGUSTA TRCE
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City | PALM CITY
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State | FL
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Zip | 34990-4786
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Country | US
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Telephone | 917-892-5187
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Fax |
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Provider Business Mailing Address
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Address Line | 2099 SW AUGUSTA TRCE
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City | PALM CITY
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State | FL
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Zip | 34990-4786
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Country | US
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Telephone | 917-892-5187
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JODY ROCHELLE MARTIN
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Credential | MSPT
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Telephone | 917-892-5187
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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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