Provider Demographics
NPI:1699702605
Name:ORTHOPEDIC MOTION, INC
Entity type:Organization
Organization Name:ORTHOPEDIC MOTION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:STRYKER
Authorized Official - Suffix:
Authorized Official - Credentials:BOCO, OTD, OTR/L
Authorized Official - Phone:702-697-7070
Mailing Address - Street 1:3233 W CHARLESTON BLVD STE 111
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1923
Mailing Address - Country:US
Mailing Address - Phone:702-697-7070
Mailing Address - Fax:
Practice Address - Street 1:653 N TOWN CENTER DR STE 507
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-0519
Practice Address - Country:US
Practice Address - Phone:702-697-7070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1002446902174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV003302088Medicaid
NV=========OtherTIN