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
—
—
Other
Enumeration date
02/06/2020
Last updated
06/03/2020
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