| Organization Name: | THE BODY BUILDER, INC. |
| NPI Number: | 1477858884 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TAMMY JO OVERTON (OWNER) |
| Mailing Address: | 1121 Walnut Street Coffeyville |
| State: | KS US |
| Postal Code: | 673375921 |
| Phone Number: | 6206886555 |
| Fax Number: | 6202513148 |
| NPI Enumeration Date: | 01/14/2011 |
| NPI Last Update Date: | 05/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171WV0202X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Contractor |
| Taxonomy Specialization: | Vehicle Modifications |
| Taxonomy Definition: | A contractor who makes modifications to private vehicles to accommodate a health condition. |