Provider Demographics
NPI:1417137449
Name:BODYSPECIFIC INC.
Entity Type:Organization
Organization Name:BODYSPECIFIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-435-8829
Mailing Address - Street 1:1800 W 14 MILE RD
Mailing Address - Street 2:SUITE G.
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-1714
Mailing Address - Country:US
Mailing Address - Phone:248-435-8829
Mailing Address - Fax:
Practice Address - Street 1:1800 W 14 MILE RD
Practice Address - Street 2:SUITE G.
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-1714
Practice Address - Country:US
Practice Address - Phone:248-435-8829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies