1477858884 NPI number — THE BODY BUILDER, INC.

Table of content: BRITTAINY LAUGHLIN MS, OTR/L (NPI 1538599899)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477858884 NPI number — THE BODY BUILDER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE BODY BUILDER, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FREEDOM MOBILITY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477858884
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1121 WALNUT STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COFFEYVILLE
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67337-5921
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
620-688-6555
Provider Business Mailing Address Fax Number:
620-251-3148

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1121 WALNUT STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COFFEYVILLE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67337-5921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-688-6555
Provider Business Practice Location Address Fax Number:
620-251-3148
Provider Enumeration Date:
01/14/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
OVERTON
Authorized Official First Name:
TAMMY
Authorized Official Middle Name:
JO
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
620-688-6555

Provider Taxonomy Codes

  • Taxonomy code: 171WV0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)