Provider Demographics
NPI:1710364252
Name:THE BODY HAUS LLC
Entity Type:Organization
Organization Name:THE BODY HAUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS, AT
Authorized Official - Phone:614-832-9783
Mailing Address - Street 1:578 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-1265
Mailing Address - Country:US
Mailing Address - Phone:614-832-9783
Mailing Address - Fax:
Practice Address - Street 1:193 E BECK ST REAR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43206-1207
Practice Address - Country:US
Practice Address - Phone:614-832-9783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH118962251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty