Provider Demographics
NPI:1083968341
Name:BODYWORKS PHYSICAL THERAPY AND WELLNESS LLC
Entity Type:Organization
Organization Name:BODYWORKS PHYSICAL THERAPY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:434-589-8865
Mailing Address - Street 1:285 JEFFERSON DR
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:VA
Mailing Address - Zip Code:22963-2404
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:285 JEFFERSON DR
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:VA
Practice Address - Zip Code:22963-2404
Practice Address - Country:US
Practice Address - Phone:434-589-8865
Practice Address - Fax:434-589-8865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-07
Last Update Date:2020-09-09
Deactivation Date:2013-01-16
Deactivation Code:
Reactivation Date:2020-09-09
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty