Provider Demographics
NPI:1992399406
Name:BODYBASICS PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:BODYBASICS PHYSICAL THERAPY, INC
Other - Org Name:BODY BASICS PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNSAKER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:951-273-7742
Mailing Address - Street 1:14252 SCHLEISMAN RD STE 203
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-4020
Mailing Address - Country:US
Mailing Address - Phone:951-273-7742
Mailing Address - Fax:951-273-7747
Practice Address - Street 1:14252 SCHLEISMAN RD STE 203
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:92880-4020
Practice Address - Country:US
Practice Address - Phone:951-273-7742
Practice Address - Fax:951-273-7747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-24
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty