| Motus Biologics And Sports Medicine Llc | |
|
5525 W 119th St Ste 250 Overland Park KS 66209-3724 | |
| (913) 808-5275 | |
| (913) 257-5150 |
| Full Name | Motus Biologics And Sports Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5525 W 119th St, Overland Park, Kansas |
| Authorized Official Name and Position | Leslie A Michaud (OWNER) |
| Authorized Official Contact | 9138085275 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Motus Biologics And Sports Medicine Llc 5525 W 119th St Ste 250 Overland Park KS 66209-3724 Ph: (913) 808-5275 | Motus Biologics And Sports Medicine Llc 5525 W 119th St Ste 250 Overland Park KS 66209-3724 Ph: (913) 808-5275 |
| NPI Number | 1215388632 |
|---|---|
| Provider Enumeration Date | 06/27/2016 |
| Last Update Date | 03/23/2017 |
| Medicare PECOS PAC ID | 8123304136 |
|---|---|
| Medicare Enrollment ID | O20170405001972 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215388632 | NPI | - | NPPES |
| 108000021 | Other | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | 04-36559 (Kansas) | Primary |
| 261QA1903X | Clinic/center - Ambulatory Surgical | 04-36559 (Kansas) | Secondary |
| Provider Name | Leslie A Michaud |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1972701019 PECOS PAC ID: 8325109333 Enrollment ID: I20170405002123 |
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