Provider Demographics
NPI:1548907702
Name:BACK TO MOTION PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:BACK TO MOTION PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:EMMONS
Authorized Official - Last Name:HOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:303-832-5577
Mailing Address - Street 1:600 N GRANT ST STE 208
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3527
Mailing Address - Country:US
Mailing Address - Phone:303-832-5577
Mailing Address - Fax:303-996-0390
Practice Address - Street 1:7821 W 38TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6185
Practice Address - Country:US
Practice Address - Phone:303-955-8091
Practice Address - Fax:303-474-6209
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BACK TO MOTION PHYSICAL THERAPY PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty