Provider Demographics
NPI:1831461094
Name:TODD'S BODY SHOP, PLLC
Entity Type:Organization
Organization Name:TODD'S BODY SHOP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:EEKHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:775-825-6450
Mailing Address - Street 1:1351 CORPORATE BLVD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-7102
Mailing Address - Country:US
Mailing Address - Phone:775-825-6450
Mailing Address - Fax:775-825-6826
Practice Address - Street 1:1351 CORPORATE BLVD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-7102
Practice Address - Country:US
Practice Address - Phone:775-825-6450
Practice Address - Fax:775-825-6826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-03
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty