Provider Demographics
NPI:1134388903
Name:BODY MECHANICS PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:BODY MECHANICS PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHARINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:AYRES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:703-737-3697
Mailing Address - Street 1:102 DRY MILL RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175
Mailing Address - Country:US
Mailing Address - Phone:703-737-3697
Mailing Address - Fax:
Practice Address - Street 1:102 DRY MILL RD SW
Practice Address - Street 2:SUITE 103
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-2635
Practice Address - Country:US
Practice Address - Phone:703-737-3697
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23058312902251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC09514Medicare PIN