Provider Demographics
NPI:1184720278
Name:BODY REPAIRS, LLC
Entity type:Organization
Organization Name:BODY REPAIRS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:COTA/L, CDI
Authorized Official - Phone:410-243-9200
Mailing Address - Street 1:PO BOX 7263
Mailing Address - Street 2:2800 MATHEWS STREET
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-0263
Mailing Address - Country:US
Mailing Address - Phone:410-243-9200
Mailing Address - Fax:410-243-9290
Practice Address - Street 1:2800 MATHEWS ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-4449
Practice Address - Country:US
Practice Address - Phone:410-243-9200
Practice Address - Fax:410-243-9290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty