Provider Demographics
NPI:1720228802
Name:BODY OF HEALTH, LLC
Entity Type:Organization
Organization Name:BODY OF HEALTH, LLC
Other - Org Name:BODY OF HEALTH CHIROPRACTIC & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:J
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-753-1287
Mailing Address - Street 1:985 NW 23RD ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-4309
Mailing Address - Country:US
Mailing Address - Phone:541-753-1287
Mailing Address - Fax:541-752-1298
Practice Address - Street 1:985 NW 23RD ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-4309
Practice Address - Country:US
Practice Address - Phone:541-753-1287
Practice Address - Fax:541-752-1298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service