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General NPI Number Information
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NPI Number | 1659564920
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Entity Type | Organization
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Legal Business Name | BODY WORKS STUDIO INC
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 10/30/2007
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Provider Practice Location Address
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Address Line | 214 ORANGE ST
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City | NEPTUNE BEACH
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State | FL
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Zip | 32266-5125
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Country | US
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Telephone | 904-246-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 214 ORANGE ST
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City | NEPTUNE BEACH
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State | FL
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Zip | 32266-5125
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Country | US
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Telephone | 904-246-4900
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/PRESIDENT
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Name | MRS. CYNTHIA BARONI CAREY
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Credential |
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Telephone | 904-246-4900
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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 | PT 12071
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License Number State | FL
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