MEDICARE: BODY TALK, 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	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1871149534
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BODY TALK, INC

Provider Business Mailing Address
First Line	:	1420 S MERIDIAN STE A
Second Line	:
City	:	PUYALLUP
State	:	WA
Zip	:	98371-6914
Country	:	US
Telephone Number	:	253-212-6146
Fax Number	:

Provider Business Practice Location Address
First Line	:	1420 S MERIDIAN STE A
Second Line	:
City	:	PUYALLUP
State	:	WA
Zip	:	98371-6914
Country	:	US
Telephone Number	:	253-212-6146
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JULIE A BROWN
Credential	:	L.M.T.
Telephone Number	:	253-212-6146

Provider Enumeration Date	:	08/17/2019
Last Update Date	:	08/17/2019

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Directions to “BODY TALK, INC ” Practice Location

Language	Start Address	Practice Location

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