Basic Information
| Provider Information | |||||||||
| NPI: | 1447430632 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BETTER BODY SOLUTIONS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4421 ROOSEVELT BLVD | ||||||||
| Address2: | STE J | ||||||||
| City: | MIDDLETOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450449023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134209999 | ||||||||
| FaxNumber: | 8774307975 | ||||||||
| Practice Location | |||||||||
| Address1: | 4421 ROOSEVELT BLVD | ||||||||
| Address2: | STE J | ||||||||
| City: | MIDDLETOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450449023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134209999 | ||||||||
| FaxNumber: | 8774307975 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2007 | ||||||||
| LastUpdateDate: | 11/06/2007 | ||||||||
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| AuthorizedOfficialLastName: | LONG | ||||||||
| AuthorizedOfficialFirstName: | KATHLEEN | ||||||||
| AuthorizedOfficialMiddleName: | MARIE | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICAL THERAPIST; CLINICAL DIRECT | ||||||||
| AuthorizedOfficialTelephone: | 5134209999 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MISS | ||||||||
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| AuthorizedOfficialCredential: | PT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.