Provider Demographics
NPI:1871527242
Name:BODYWORKS, INC.
Entity type:Organization
Organization Name:BODYWORKS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:336-918-7476
Mailing Address - Street 1:PO BOX 1346
Mailing Address - Street 2:
Mailing Address - City:KING
Mailing Address - State:NC
Mailing Address - Zip Code:27021-1346
Mailing Address - Country:US
Mailing Address - Phone:336-918-7476
Mailing Address - Fax:336-983-4915
Practice Address - Street 1:320 E KING ST
Practice Address - Street 2:SUITE B
Practice Address - City:KING
Practice Address - State:NC
Practice Address - Zip Code:27021-9162
Practice Address - Country:US
Practice Address - Phone:336-918-7476
Practice Address - Fax:336-983-4915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2598225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCB0102OtherREHABILITATIVE MEDICINE
NC017VVOtherREHABILITATIVE MEDICINE
NCJ454OtherREHABILITATIVE MEDICINE
NC017VVOtherREHABILITATIVE MEDICINE