Provider Demographics
NPI:1821618646
Name:BODY FIX 180, LLC
Entity Type:Organization
Organization Name:BODY FIX 180, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:TIMM
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:940-489-2407
Mailing Address - Street 1:1872 PHEASANT DR
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76088-2034
Mailing Address - Country:US
Mailing Address - Phone:940-489-2407
Mailing Address - Fax:
Practice Address - Street 1:350 TIMBER WILD DR
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76087-8017
Practice Address - Country:US
Practice Address - Phone:940-489-2407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy