Provider Demographics
NPI:1770618779
Name:BETTER BODY PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:BETTER BODY PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:D
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:352-854-4017
Mailing Address - Street 1:9401 SW HIGHWAY 200
Mailing Address - Street 2:SUITE 2001
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34481-9612
Mailing Address - Country:US
Mailing Address - Phone:352-854-4017
Mailing Address - Fax:352-854-4389
Practice Address - Street 1:9401 SW HIGHWAY 200
Practice Address - Street 2:SUITE 2001
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-9612
Practice Address - Country:US
Practice Address - Phone:352-854-4017
Practice Address - Fax:352-854-4389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2014-05-06
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
K3137Medicare PIN