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General NPI Number Information
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NPI Number | 1790076230
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Entity Type | Organization
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Legal Business Name | BODY OF HEALTH AND LIFE, LLC
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Dates
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Enumeration Date | 05/02/2011
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Last Update Date | 03/16/2017
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Provider Practice Location Address
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Address Line | 2321 HENRY CLOWER BLVD STE A
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City | SNELLVILLE
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State | GA
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Zip | 30078-7419
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Country | US
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Telephone | 678-344-0050
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Fax | 678-344-0050
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Provider Business Mailing Address
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Address Line | 2321 HENRY CLOWER BLVD. SW STE A
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City | SNELLVILLE
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State | GA
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Zip | 30078-2202
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Country | US
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Telephone | 678-344-0050
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Fax | 678-344-0050
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JULIE DAVIS MILLS-WATSON
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Credential | CMT, LLCC
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Telephone | 678-344-0050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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