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General NPI Number Information
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NPI Number | 1699019687
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Entity Type | Organization
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Legal Business Name | THE BODY SHOPPE PHYISCAL THERAPY
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Dates
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Enumeration Date | 11/15/2012
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Last Update Date | 11/15/2012
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Provider Practice Location Address
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Address Line | 312 LIVE OAK ST
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City | BEAUFORT
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State | NC
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Zip | 28516-1910
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Country | US
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Telephone | 252-732-4618
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Fax |
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Provider Business Mailing Address
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Address Line | 312 LIVE OAK ST
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City | BEAUFORT
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State | NC
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Zip | 28516-1910
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PT
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Name | KATHERINE WOODS PRICE
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Credential | PT
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Telephone | 252-732-4618
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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 | 11676
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License Number State | NC
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