| NPI | 1477897023 |
|---|---|
| Doing Business As | 1BODY4LIFE |
| Entity Type | Organization |
| Authorized Contact | DAVID S. FOOTERMAN President 815-209-2525 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2012-11-20 |
| Last Update Date | 2012-11-20 |