MEDICARE: BODIES IN MOTION PHYSICAL THERAPY AND WELLNESS 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	225100000X	Physical Therapist	4554024	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285621565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BODIES IN MOTION PHYSICAL THERAPY AND WELLNESS INC.

Provider Business Mailing Address
First Line	:	2499 S DELAWARE AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53207-1941
Country	:	US
Telephone Number	:	414-482-2469
Fax Number	:	414-482-2748

Provider Business Practice Location Address
First Line	:	2499 S DELAWARE AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53207-1941
Country	:	US
Telephone Number	:	414-482-2469
Fax Number	:	414-747-8686

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. KATHLEEN ANN HOWELL
Credential	:	PT
Telephone Number	:	414-482-2469

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	08/04/2016

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