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General NPI Number Information
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NPI Number | 1407273857
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Entity Type | Organization
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Legal Business Name | BODY MECHANICS PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 03/24/2014
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 907 S MAIN ST
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City | BUENA VISTA
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State | CO
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Zip | 81211
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Country | US
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Telephone | 719-966-5227
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Fax | 719-466-2008
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Provider Business Mailing Address
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Address Line | PO BOX 1275
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City | BUENA VISTA
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State | CO
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Zip | 81211
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Country | US
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Telephone | 719-966-5227
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Fax | 719-466-2008
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Authorized Official
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Title or Position | OWNER, PT
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Name | GARRETT BOWDLE
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Credential | PT, DPT, OCS
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Telephone | 719-966-5227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PTL0004290
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License Number State | CO
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