Provider Demographics
NPI:1114201910
Name:BODY N MOTION
Entity type:Organization
Organization Name:BODY N MOTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAFFERTY
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:307-337-1624
Mailing Address - Street 1:201 E 2ND ST
Mailing Address - Street 2:SUITE 14
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2582
Mailing Address - Country:US
Mailing Address - Phone:307-337-1624
Mailing Address - Fax:307-337-1626
Practice Address - Street 1:201 E 2ND ST
Practice Address - Street 2:SUITE 14
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2582
Practice Address - Country:US
Practice Address - Phone:307-337-1624
Practice Address - Fax:307-337-1626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty