Provider Demographics
NPI:1457795106
Name:ONE BODY LLC
Entity Type:Organization
Organization Name:ONE BODY LLC
Other - Org Name:SHEILA T. JOHNSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/LMT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:T
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:985-688-6390
Mailing Address - Street 1:302 CHURCH STREET
Mailing Address - Street 2:SUITE C
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360
Mailing Address - Country:US
Mailing Address - Phone:985-688-6390
Mailing Address - Fax:
Practice Address - Street 1:302 CHURCH STREET
Practice Address - Street 2:SUITE C
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360
Practice Address - Country:US
Practice Address - Phone:985-688-6390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALMT#7266225700000X
LA#OC-22613225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty