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Organization
BACK IN MOTION INTEGRATED MEDICINE PLLC
Active
Organization
BACK IN MOTION INTEGRATED MEDICINE PLLC
Active
Other names
Back in Motion Integrated Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ALAN GANSCHOW (OWNER)
(817) 764-2291
Entity
Organization
Contact information
Practice address
104 GRAPEVINE HWY STE 400, HURST, TX 76054-2438
(817) 458-2400
(817) 485-2475
Mailing address
PO BOX 1066, COLLEYVILLE, TX 76034-1066
(817) 485-2400
(817) 458-2475
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
02/06/2020
Last updated
06/03/2020
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