| Organization Name: | BETTER BODY BOOT CAMP INC |
| NPI Number: | 1043577935 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANIEL SUSSAN (SALES) |
| Mailing Address: | 23280 W Lone Tree Ln Lake Zurich |
| State: | IL US |
| Postal Code: | 600479063 |
| Phone Number: | 8473230326 |
| Fax Number: | |
| NPI Enumeration Date: | 04/16/2012 |
| NPI Last Update Date: | 08/17/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BN1400X |
| License Number: | 1043577935 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Nursing Facility Supplies |
| Taxonomy Definition: | |