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General NPI Number Information
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NPI Number | 1710364252
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Entity Type | Organization
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Legal Business Name | THE BODY HAUS LLC
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Dates
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Enumeration Date | 05/05/2015
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Last Update Date | 05/05/2015
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Provider Practice Location Address
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Address Line | 193 E BECK ST REAR
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City | COLUMBUS
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State | OH
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Zip | 43206-1207
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Country | US
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Telephone | 614-832-9783
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Fax |
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Provider Business Mailing Address
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Address Line | 578 S 5TH ST
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City | COLUMBUS
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State | OH
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Zip | 43206-1265
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Country | US
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Telephone | 614-832-9783
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | CRYSTAL SANTIN
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Credential | PT, DPT, OCS, AT
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Telephone | 614-832-9783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 11896
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License Number State | OH
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