Provider Demographics
NPI:1053930164
Name:MADE FOR MOTION PEDIATRIC THERAPY
Entity type:Organization
Organization Name:MADE FOR MOTION PEDIATRIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, C/NDT
Authorized Official - Phone:903-918-9282
Mailing Address - Street 1:25619 CANYON SANDS LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-4351
Mailing Address - Country:US
Mailing Address - Phone:903-918-9282
Mailing Address - Fax:832-201-8800
Practice Address - Street 1:25619 CANYON SANDS LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-4351
Practice Address - Country:US
Practice Address - Phone:903-918-9282
Practice Address - Fax:832-201-8800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty