Provider Demographics
NPI:1750552246
Name:BODYSENSE PT, LLC
Entity type:Organization
Organization Name:BODYSENSE PT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:O'BRIEN
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:301-432-8585
Mailing Address - Street 1:6 TIGER WAY
Mailing Address - Street 2:
Mailing Address - City:BOONSBORO
Mailing Address - State:MD
Mailing Address - Zip Code:21713-2084
Mailing Address - Country:US
Mailing Address - Phone:301-432-8585
Mailing Address - Fax:301-432-1987
Practice Address - Street 1:6 TIGER WAY
Practice Address - Street 2:
Practice Address - City:BOONSBORO
Practice Address - State:MD
Practice Address - Zip Code:21713-2084
Practice Address - Country:US
Practice Address - Phone:301-432-8585
Practice Address - Fax:301-432-1987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4199499P0002Medicaid