Provider Demographics
NPI:1558621292
Name:MOTION PERFORMANCE GROUP SCOTTSDALE PLLC
Entity type:Organization
Organization Name:MOTION PERFORMANCE GROUP SCOTTSDALE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-214-2501
Mailing Address - Street 1:8250 E ARABIAN TRL
Mailing Address - Street 2:108
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-1855
Mailing Address - Country:US
Mailing Address - Phone:517-214-2501
Mailing Address - Fax:
Practice Address - Street 1:8250 E ARABIAN TRL
Practice Address - Street 2:108
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-1855
Practice Address - Country:US
Practice Address - Phone:517-214-2501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-28
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3744111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty