| Organization Name: | BODY WISE THERAPY SERVICES LLC |
| NPI Number: | 1104981505 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHERYL LYNN MURPHY (OWNER MANAGER) |
| Mailing Address: | 832 Highway 60 Socorro |
| State: | NM US |
| Postal Code: | 87801 |
| Phone Number: | 5058381100 |
| Fax Number: | 5058380394 |
| NPI Enumeration Date: | 12/26/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 007210 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |