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General NPI Number Information
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NPI Number | 1760848717
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Entity Type | Organization
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Legal Business Name | IN MOTION PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 01/06/2016
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Last Update Date | 01/06/2016
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Provider Practice Location Address
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Address Line | 40 BOLTON RD
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City | NEWTONVILLE
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State | MA
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Zip | 02460-2129
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Country | US
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Telephone | 617-968-3999
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Fax |
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Provider Business Mailing Address
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Address Line | 40 BOLTON RD
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City | NEWTONVILLE
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State | MA
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Zip | 02460-2129
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Country | US
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Telephone | 617-968-3999
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | LISA M SCIALLA GRIGGS
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Credential | DPT
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Telephone | 617-968-3999
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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 | 13393
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License Number State | MA
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