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General NPI Number Information
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NPI Number | 1487706586
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Entity Type | Organization
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Legal Business Name | BODYWORKS PHYSIOTHERAPY CLINIC
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 05/15/2013
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Provider Practice Location Address
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Address Line | 333 N PALM CANYON DR SUITE # 114
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City | PALM SPRINGS
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State | CA
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Zip | 92262-5658
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Country | US
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Telephone | 760-327-4244
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Fax | 760-327-4284
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Provider Business Mailing Address
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Address Line | 333 N PALM CANYON DR SUITE # 114
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City | PALM SPRINGS
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State | CA
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Zip | 92262-5658
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Country | US
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Telephone | 760-327-4244
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Fax | 760-327-4284
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID RICHARD WILSON
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Credential | PT
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Telephone | 760-327-4244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 17947
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License Number State | CA
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