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General NPI Number Information
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NPI Number | 1184492803
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Entity Type | Organization
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Legal Business Name | BODY FITNESS WITH DOTTIE LLC
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Dates
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Enumeration Date | 12/12/2023
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Last Update Date | 12/12/2023
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Provider Practice Location Address
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Address Line | 1509 JERRY CLOWER BLVD
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City | YAZOO CITY
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State | MS
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Zip | 39194-2718
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Country | US
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Telephone | 769-226-6650
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Fax |
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Provider Business Mailing Address
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Address Line | 1509 JERRY CLOWER BLVD
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City | YAZOO CITY
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State | MS
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Zip | 39194-2718
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Country | US
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Telephone | 769-226-6650
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Fax |
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Authorized Official
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Title or Position | ORGANIZER/HEALTH COACH
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Name | DOROTHY COLLINS
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Credential |
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Telephone | 769-226-6650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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