Provider Demographics
NPI:1467789388
Name:GRABILLS BODY SHOP, LLC
Entity Type:Organization
Organization Name:GRABILLS BODY SHOP, LLC
Other - Org Name:DBA THE BODY SHOP PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:GRABILL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:606-796-5000
Mailing Address - Street 1:PO BOX 600
Mailing Address - Street 2:
Mailing Address - City:VANCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41179-0600
Mailing Address - Country:US
Mailing Address - Phone:606-796-5000
Mailing Address - Fax:606-796-5001
Practice Address - Street 1:787 FAIRLANE DR
Practice Address - Street 2:
Practice Address - City:VANCEBURG
Practice Address - State:KY
Practice Address - Zip Code:41179-8975
Practice Address - Country:US
Practice Address - Phone:606-796-5000
Practice Address - Fax:606-796-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-13
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPT003827261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy