Provider Demographics
NPI:1386721850
Name:BODY DYNAMICS, INC.
Entity type:Organization
Organization Name:BODY DYNAMICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-440-5776
Mailing Address - Street 1:2660 CANYON BLVD
Mailing Address - Street 2:SUITE A-4
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-6748
Mailing Address - Country:US
Mailing Address - Phone:303-440-5776
Mailing Address - Fax:303-546-0020
Practice Address - Street 1:2660 CANYON BLVD
Practice Address - Street 2:SUITE A-4
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-6748
Practice Address - Country:US
Practice Address - Phone:303-440-5776
Practice Address - Fax:303-546-0020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO804197Medicare ID - Type Unspecified