Provider Demographics
NPI:1972700482
Name:ABE L BODIES CORPORATION
Entity Type:Organization
Organization Name:ABE L BODIES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:ISHIBASHI
Authorized Official - Suffix:
Authorized Official - Credentials:OTR-L
Authorized Official - Phone:775-852-4342
Mailing Address - Street 1:3985 CASA BLANCA RD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-5380
Mailing Address - Country:US
Mailing Address - Phone:775-852-4342
Mailing Address - Fax:
Practice Address - Street 1:150 W HUFFAKER LN
Practice Address - Street 2:SUITE 105
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2092
Practice Address - Country:US
Practice Address - Phone:775-852-4342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0001174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV$$$$$$$$$OtherSOCIAL SECURITY NUMBER