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General NPI Number Information
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NPI Number | 1912149253
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Entity Type | Organization
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Legal Business Name | BACK IN MOTION THERAPY, PC
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Dates
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Enumeration Date | 04/01/2009
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Last Update Date | 04/01/2009
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Provider Practice Location Address
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Address Line | 1764 TROY RD.
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City | WASHINGTON
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State | IN
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Zip | 47501
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Country | US
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Telephone | 812-709-0454
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Fax | 614-807-6433
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Provider Business Mailing Address
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Address Line | 319 6TH STREET PO BOX 575
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City | SHOALS
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State | IN
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Zip | 47581-0575
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Country | US
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Telephone | 812-709-0454
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Fax | 614-807-6433
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MRS. DANA L JONES
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Credential | PT
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Telephone | 812-709-0454
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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 | 05007803A
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License Number State | IN
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