| Organization Name: | BODY DYNAMIC PHYSICAL THERAPY & PILATES WELLNESS |
| NPI Number: | 1104152925 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REBECCA C. MASTRODICASA (PHYSICAL THERAPIST/TREASURER) |
| Mailing Address: | 1282 White Oaks Rd Campbell |
| State: | CA US |
| Postal Code: | 95008 |
| Phone Number: | 4085506076 |
| Fax Number: | 4086081970 |
| NPI Enumeration Date: | 10/29/2009 |
| NPI Last Update Date: | 10/29/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 24763 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |