Provider Demographics
NPI:1467789297
Name:BODY THERAPEUTICS, LLC
Entity Type:Organization
Organization Name:BODY THERAPEUTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CARON
Authorized Official - Suffix:
Authorized Official - Credentials:LIC AC
Authorized Official - Phone:508-641-2198
Mailing Address - Street 1:102 SHORE DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-3154
Mailing Address - Country:US
Mailing Address - Phone:508-641-2198
Mailing Address - Fax:
Practice Address - Street 1:102 SHORE DR
Practice Address - Street 2:SUITE 104
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-3154
Practice Address - Country:US
Practice Address - Phone:508-641-2198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty