Healthcare Provider Details

I. General information

NPI: 1437806585
Provider Name (Legal Business Name): LYNN ANN BODIE LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2022
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 LEWIS CENTER RD STE M
LEWIS CENTER OH
43035-8491
US

IV. Provider business mailing address

180 BIRCH DR
LEWIS CENTER OH
43035-9285
US

V. Phone/Fax

Practice location:
  • Phone: 772-349-6270
  • Fax:
Mailing address:
  • Phone: 772-349-6270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.026332
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: