MEDICARE: BOD PAIN MANAGEMENT AND WELLNESS CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1578420360
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOD PAIN MANAGEMENT AND WELLNESS CENTER LLC

Provider Business Mailing Address
First Line	:	313 PARK AVE STE 203
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22046-3303
Country	:	US
Telephone Number	:	703-637-3626
Fax Number	:

Provider Business Practice Location Address
First Line	:	313 PARK AVE STE 203
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22046-3303
Country	:	US
Telephone Number	:	703-637-3626
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. DILHAN KASIMCAN
Credential	:
Telephone Number	:	571-296-5419

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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