Provider Demographics
NPI:1366937328
Name:IN-MOTION PROSTHETICS & ORTHOTICS, LLC
Entity type:Organization
Organization Name:IN-MOTION PROSTHETICS & ORTHOTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALZ
Authorized Official - Suffix:
Authorized Official - Credentials:CP,BOCO
Authorized Official - Phone:586-666-3280
Mailing Address - Street 1:25915 HARPER AVE STE D
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-3770
Mailing Address - Country:US
Mailing Address - Phone:586-666-3280
Mailing Address - Fax:
Practice Address - Street 1:25915 HARPER AVE STE D
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-3770
Practice Address - Country:US
Practice Address - Phone:586-666-3280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-22
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier