Provider Demographics
NPI:1093807810
Name:BODY GRAPHICS, LLC
Entity Type:Organization
Organization Name:BODY GRAPHICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILL-BOWER
Authorized Official - Suffix:
Authorized Official - Credentials:CMF
Authorized Official - Phone:314-849-5009
Mailing Address - Street 1:8887 RED OAK DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126-1933
Mailing Address - Country:US
Mailing Address - Phone:314-849-5009
Mailing Address - Fax:314-849-5301
Practice Address - Street 1:8887 RED OAK DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126-1933
Practice Address - Country:US
Practice Address - Phone:314-849-5009
Practice Address - Fax:314-849-5301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO12763047332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies