Healthcare Provider Details

I. General information

NPI: 1851945802
Provider Name (Legal Business Name): BEAUTIFUL BODY & MORE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2019
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 BENTON RD STE 900
BOSSIER CITY LA
71111-4194
US

IV. Provider business mailing address

1907 BENTON RD STE 900
BOSSIER CITY LA
71111-4194
US

V. Phone/Fax

Practice location:
  • Phone: 318-773-9352
  • Fax:
Mailing address:
  • Phone: 318-716-1507
  • Fax: 318-716-1508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code224900000X
TaxonomyMastectomy Fitter
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. DAISY SCOTT
Title or Position: OWNER
Credential:
Phone: 318-716-1507