Provider Demographics
NPI:1427845197
Name:MIND TO MOTION PHYSICAL THERAPY
Entity type:Organization
Organization Name:MIND TO MOTION PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KESENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ERORAHA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:213-290-0247
Mailing Address - Street 1:PO BOX 88225
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90009-8225
Mailing Address - Country:US
Mailing Address - Phone:213-290-0247
Mailing Address - Fax:
Practice Address - Street 1:1930 W 65TH PL
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90047-1703
Practice Address - Country:US
Practice Address - Phone:213-290-0247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy