Organization
KIDS IN MOTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY HYDORN (PT)
(248) 684-9610
Entity
Organization
Contact information
Practice address
2636 S. MILFORD ROAD, HIGHLAND, MI 48357
(248) 684-9610
Mailing address
6281 MIDDLE LAKE ROAD, CLARKSTON, MI 48346
(248) 202-7510
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
5502004079
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22
TAXONOMY
MI
Enumeration date
01/28/2015
Last updated
01/28/2015
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