MEDICARE: MEDICAL MOTION, L.L.C.

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1407279920
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL MOTION, L.L.C.

Provider Business Mailing Address
First Line	:	PO BOX 1148
Second Line	:
City	:	JENKS
State	:	OK
Zip	:	74037-1148
Country	:	US
Telephone Number	:	918-663-9494
Fax Number	:	918-663-6339

Provider Business Practice Location Address
First Line	:	8718 S PEORIA AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74132-2829
Country	:	US
Telephone Number	:	918-271-2788
Fax Number	:	918-663-6339

Authorized Official
Title or Position	:	OWNER
Name	:	CORY THOMAS WOODHAM
Credential	:
Telephone Number	:	918-271-2788

Provider Enumeration Date	:	02/04/2014
Last Update Date	:	02/27/2017

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