Provider Demographics
NPI:1659659548
Name:BODY MECHANIX LLC
Entity Type:Organization
Organization Name:BODY MECHANIX LLC
Other - Org Name:BODY MECHANIX ACUPUNCTURE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, AP, DOM, MSOM
Authorized Official - Phone:786-445-0106
Mailing Address - Street 1:7608 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-3294
Mailing Address - Country:US
Mailing Address - Phone:786-445-0106
Mailing Address - Fax:
Practice Address - Street 1:7608 ROSEWOOD DR
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-3294
Practice Address - Country:US
Practice Address - Phone:786-445-0106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-27
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2684171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty