| NPI | 1780826396 |
|---|---|
| Doing Business As | BODYLOGICMD OF ENCINO |
| Entity Type | Organization |
| Authorized Contact | TRAVIS DEUSON Director 877-835-1536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA A69979) |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2009-05-08 |