MEDICARE: BODIED BY B LLC

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	335E00000X	Prosthetic/Orthotic Supplier
2	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1982553731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BODIED BY B LLC

Provider Business Mailing Address
First Line	:	2227 N GLENN AVE APT 202
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93704-6309
Country	:	US
Telephone Number	:	213-697-1250
Fax Number	:

Provider Business Practice Location Address
First Line	:	2227 N GLENN AVE APT 202
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93704-6309
Country	:	US
Telephone Number	:	213-697-1250
Fax Number	:

Authorized Official
Title or Position	:	SPECIALIST
Name	:	BRITTANY GRIMMETT
Credential	:	CRANIAL PROSTHESES
Telephone Number	:	618-960-0190

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	02/17/2026

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Directions to “BODIED BY B LLC ” Practice Location

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