Provider Demographics
NPI:1063259190
Name:RECOVERY IN MOTION PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:RECOVERY IN MOTION PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TASHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUFF
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:704-559-9157
Mailing Address - Street 1:1515 MOCKINGBIRD LN STE 400
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3298
Mailing Address - Country:US
Mailing Address - Phone:704-559-9157
Mailing Address - Fax:
Practice Address - Street 1:6420 REA RD STE A2
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-0771
Practice Address - Country:US
Practice Address - Phone:704-559-9157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-15
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty