| NPI | 1013494327 |
|---|---|
| Doing Business As | BODYLOGICMD OF PHOENIX-CHANDLER |
| Entity Type | Organization |
| Authorized Contact | JOSEPH MAZZEI Owner 312-608-4086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: AZ 007596) |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2021-10-05 |