Provider Demographics
NPI:1851003214
Name:BODYWAVEZ FITNESS
Entity Type:Organization
Organization Name:BODYWAVEZ FITNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WINSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-329-3230
Mailing Address - Street 1:5214 TROTTERS GLEN DR
Mailing Address - Street 2:
Mailing Address - City:UPPR MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-2903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:919 FLORIDA AVE NW APT 602
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-5048
Practice Address - Country:US
Practice Address - Phone:734-329-3230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty