MEDICARE: BEYOND BODY PHYSIOTHERAPY & WELLNESS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1821665506
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEYOND BODY PHYSIOTHERAPY & WELLNESS, INC.

Provider Business Mailing Address
First Line	:	11340 W OLYMPIC BLVD STE 280
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1698
Country	:	US
Telephone Number	:	310-844-0720
Fax Number	:

Provider Business Practice Location Address
First Line	:	11340 W OLYMPIC BLVD STE 280
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1698
Country	:	US
Telephone Number	:	310-844-0720
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	HEMA DEVNANI
Credential	:	PT
Telephone Number	:	310-844-0720

Provider Enumeration Date	:	06/09/2021
Last Update Date	:	06/09/2021

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