Provider Demographics
NPI:1922126408
Name:BODIES IN BALANCE PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:BODIES IN BALANCE PHYSICAL THERAPY, PLLC
Other - Org Name:BODIES IN BALANCE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT AND OWNER OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:423-756-4781
Mailing Address - Street 1:516 TREMONT ST.
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405
Mailing Address - Country:US
Mailing Address - Phone:423-756-4781
Mailing Address - Fax:423-756-4782
Practice Address - Street 1:516 TREMONT ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-4153
Practice Address - Country:US
Practice Address - Phone:423-756-4781
Practice Address - Fax:423-756-4782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNNONE FOR GROUP225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty