Provider Demographics
NPI:1861691016
Name:BODALIA BODY BASICS, INC
Entity type:Organization
Organization Name:BODALIA BODY BASICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEHAL
Authorized Official - Middle Name:K
Authorized Official - Last Name:BODALIA
Authorized Official - Suffix:
Authorized Official - Credentials:BS, CEO
Authorized Official - Phone:251-947-7565
Mailing Address - Street 1:18601 E SILVERHILL AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROBERTSDALE
Mailing Address - State:AL
Mailing Address - Zip Code:36567-3703
Mailing Address - Country:US
Mailing Address - Phone:251-947-7565
Mailing Address - Fax:251-947-2697
Practice Address - Street 1:18601 E SILVERHILL AVE
Practice Address - Street 2:SUITE A
Practice Address - City:ROBERTSDALE
Practice Address - State:AL
Practice Address - Zip Code:36567-3703
Practice Address - Country:US
Practice Address - Phone:251-947-7565
Practice Address - Fax:251-947-2697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty