Provider Demographics
NPI:1740434695
Name:BODY EASE RI PHYSICAL THERAPY CENTRE LLC
Entity type:Organization
Organization Name:BODY EASE RI PHYSICAL THERAPY CENTRE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:C
Authorized Official - Last Name:SWEETMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:401-295-2374
Mailing Address - Street 1:400 S COUNTY TRL STE A205
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:RI
Mailing Address - Zip Code:02822-3540
Mailing Address - Country:US
Mailing Address - Phone:401-295-2374
Mailing Address - Fax:401-295-2370
Practice Address - Street 1:400 S COUNTY TRL STE A205
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:RI
Practice Address - Zip Code:02822-3540
Practice Address - Country:US
Practice Address - Phone:401-295-2374
Practice Address - Fax:401-295-2370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI709003342Medicare PIN