MEDICARE: UPWARD MOTION, LLC

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	174H00000X	Health Educator	1390786	NM

General Provider Information

NPI Number	:	1679819023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPWARD MOTION, LLC

Provider Business Mailing Address
First Line	:	336 ADAMS ST SE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87108-2837
Country	:	US
Telephone Number	:	505-268-1231
Fax Number	:

Provider Business Practice Location Address
First Line	:	336 ADAMS ST SE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87108-2837
Country	:	US
Telephone Number	:	505-268-1231
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LUIS MIGUEL ALVIDREZ
Credential	:	B.S EXERCISE SCIENCE
Telephone Number	:	505-268-1231

Provider Enumeration Date	:	12/12/2012
Last Update Date	:	12/12/2012

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Directions to “UPWARD MOTION, LLC ” Practice Location

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