=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730061516
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BACK IN MOTION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2025
-----------------------------------------------------
Last Update Date | 07/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11405 N PENN ST STE 102
-----------------------------------------------------
City | CARMEL
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46032-6905
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-343-6904
-----------------------------------------------------
Fax | 317-975-3913
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11405 N PENN ST STE 102
-----------------------------------------------------
City | CARMEL
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46032-6905
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-343-6904
-----------------------------------------------------
Fax | 317-975-3913
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | BRITTANY N MCKINNEY
-----------------------------------------------------
Credential | LPN, HFA
-----------------------------------------------------
Telephone | 317-666-0316
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------