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 Clinic/Center (Licence: AZ 007596) |
Enumeration Date | 2018-07-20 |
Last Update Date | 2021-10-05 |