# BACK IN MOTION, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134242993
- **Authorized official:** SUSAN CORBETT (BILLING REPRESENTATIVE)
- **Authorized official phone:** (207) 497-2996

## Contact information

- **Practice address:** 66 MAIN ST, MILBRIDGE, ME 04658
- **Practice address phone:** (207) 497-2996
- **Practice address fax:** (207) 497-3467
- **Mailing address:** PO BOX 157, MILBRIDGE, ME 04658-0157
- **Mailing address phone:** (207) 497-2996
- **Mailing address fax:** (207) 497-3467

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 55820 | ME | Yes |

## Other

- **Enumeration date:** 04/09/2007
- **Last updated:** 02/02/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 098672 | BCBS | ME |
| 05 | — | 210390000 | — | ME |
| 01 | — | 2467127 | AETNA | ME |
| 01 | — | 2485306 | AETNA | ME |
| 01 | — | 350052171 | RAILROAD MEDICARE | ME |
| 01 | — | M183695 | CIGNA | ME |
| 01 | — | MN4133 | HARVARD PILGRIM | ME |