MEDICARE: TOTAL MOTION PHYSICAL THERAPY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist		NC

General Provider Information

NPI Number	:	1235197112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL MOTION PHYSICAL THERAPY INC

Provider Business Mailing Address
First Line	:	4030 WAKE FOREST RD
Second Line	:	SUITE 211
City	:	RALEIGH
State	:	NC
Zip	:	27609-6800
Country	:	US
Telephone Number	:	919-872-2828
Fax Number	:	919-872-8138

Provider Business Practice Location Address
First Line	:	4030 WAKE FOREST RD
Second Line	:	SUITE 211
City	:	RALEIGH
State	:	NC
Zip	:	27609-6800
Country	:	US
Telephone Number	:	919-872-2828
Fax Number	:	919-872-8138

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	THOMAS DALONZO-BAKER
Credential	:	MPT
Telephone Number	:	919-872-2828

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	02/05/2015

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