| NPI | 1134524234 | 
|---|---|
| Former Legal Business Name | BODY SHOP PHYSICAL THERAPY AND WELLNESS CENTER, LLC | 
| Entity Type | Organization | 
| Authorized Contact | JASON CHRISTOPHER DORSCH D PT/Owner 928-214-7303  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 9032)  | 
| Enumeration Date | 2014-10-31 | 
| Last Update Date | 2021-05-25 |