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General NPI Number Information
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NPI Number | 1669907432
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Entity Type | Organization
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Legal Business Name | HEALTH IN MOTION, LLC
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Dates
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Enumeration Date | 04/28/2017
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Last Update Date | 06/27/2017
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Provider Practice Location Address
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Address Line | 250 PEQUOT AVE
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City | SOUTHPORT
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State | CT
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Zip | 06890-1387
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Country | US
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Telephone | 203-292-8722
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Fax |
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Provider Business Mailing Address
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Address Line | 75 SASAPEQUAN RD
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City | FAIRFIELD
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State | CT
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Zip | 06824-7205
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Country | US
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Telephone | 203-292-6063
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MRS. DIANE DODD SELL
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Credential | DPT
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Telephone | 203-803-8090
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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 | 007823
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License Number State | CT
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