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General NPI Number Information
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NPI Number | 1770446841
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Entity Type | Organization
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Legal Business Name | BODY VITALITY LLC
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 2174 E WILLIAMS FIELD RD STE 200
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City | GILBERT
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State | AZ
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Zip | 85295-0160
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Country | US
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Telephone | 602-824-8466
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Fax | 833-973-5655
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Provider Business Mailing Address
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Address Line | 2174 E WILLIAMS FIELD RD STE 200
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City | GILBERT
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State | AZ
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Zip | 85295-0160
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Country | US
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Telephone | 602-824-8466
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Fax | 833-973-5655
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | PAUL SCHMIDT
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Credential | PA
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Telephone | 602-824-8466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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