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General NPI Number Information
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NPI Number | 1801175583
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Entity Type | Organization
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Legal Business Name | IN MOTION ORTHOTICS, LLC
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Dates
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Enumeration Date | 08/11/2011
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Last Update Date | 08/11/2011
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Provider Practice Location Address
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Address Line | 224 MEADOWLANE ST
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City | EUPORA
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State | MS
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Zip | 39744-2219
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Country | US
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Telephone | 662-258-8201
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Fax | 662-258-8202
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Provider Business Mailing Address
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Address Line | 224 MEADOWLANE ST
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City | EUPORA
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State | MS
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Zip | 39744-2219
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Country | US
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Telephone | 662-258-8201
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Fax | 662-258-8202
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOEY LEON CARNEY
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Credential | BOCO
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Telephone | 662-258-8201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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