| Back in Motion Integrated Medicine | |
|
104 Grapevine Hwy Ste 400 Hurst TX 76054-2438 | |
| (817) 458-2400 | |
| (817) 485-2475 |
| Full Name | Back in Motion Integrated Medicine |
|---|---|
| Speciality | General Practice |
| Location | 104 Grapevine Hwy Ste 400, Hurst, Texas |
| Authorized Official Name and Position | Michael Alan Ganschow (OWNER) |
| Authorized Official Contact | 8177642291 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Back in Motion Integrated Medicine Po Box 1066 Colleyville TX 76034-1066 Ph: (817) 485-2400 | Back in Motion Integrated Medicine 104 Grapevine Hwy Ste 400 Hurst TX 76054-2438 Ph: (817) 458-2400 |
| NPI Number | 1194357293 |
|---|---|
| Provider Enumeration Date | 02/06/2020 |
| Last Update Date | 06/03/2020 |
| Certification Date | 06/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194357293 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
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