Organization
BRIAN A SURAGE PT MOMT CSCS PC
Active
Other names
In Motion Physical Therapy/Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN A SURAGE PT MOMT CSCS (OWNER)
(719) 268-8939
Entity
Organization
Contact information
Practice address
4209 CENTENNIAL BLVD, COLORADO SPRINGS, CO 80907-3770
(719) 268-8939
(719) 268-0944
Mailing address
4209 CENTENNIAL BLVD, COLORADO SPRINGS, CO 80907-3770
(719) 268-8939
(719) 268-0944
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
2802
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
GROUP MEDICARE PENDING
CO
Enumeration date
10/24/2013
Last updated
10/24/2013
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