Provider Demographics
NPI:1699370981
Name:BODY RX
Entity Type:Organization
Organization Name:BODY RX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCVAY - STRAUB
Authorized Official - Suffix:
Authorized Official - Credentials:IMT, ART, NKT, AIM,
Authorized Official - Phone:707-327-8245
Mailing Address - Street 1:808 DONAHUE ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-5434
Mailing Address - Country:US
Mailing Address - Phone:707-327-8245
Mailing Address - Fax:
Practice Address - Street 1:808 DONAHUE ST
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-5434
Practice Address - Country:US
Practice Address - Phone:707-327-8245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty