Provider Demographics
NPI:1669875415
Name:BODY WERKS PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:BODY WERKS PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOLIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:MANDELL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:716-680-8180
Mailing Address - Street 1:276 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FREDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:14063-2234
Mailing Address - Country:US
Mailing Address - Phone:716-680-8180
Mailing Address - Fax:716-680-8181
Practice Address - Street 1:276 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FREDONIA
Practice Address - State:NY
Practice Address - Zip Code:14063-2234
Practice Address - Country:US
Practice Address - Phone:716-680-8180
Practice Address - Fax:716-680-8181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-07
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021033225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty