Provider Demographics
NPI:1215016241
Name:BODY & SOUL THERAPY LLC
Entity Type:Organization
Organization Name:BODY & SOUL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SCHINDLBECK
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:952-237-0386
Mailing Address - Street 1:1046 COUNTY ROAD J
Mailing Address - Street 2:
Mailing Address - City:FRIENDSHIP
Mailing Address - State:WI
Mailing Address - Zip Code:53934-9705
Mailing Address - Country:US
Mailing Address - Phone:962-237-0386
Mailing Address - Fax:
Practice Address - Street 1:515 JUNCTION RD
Practice Address - Street 2:SUITE 2100
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-2151
Practice Address - Country:US
Practice Address - Phone:952-237-0386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4059-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty