# BODY MECHANIX

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417319781
- **Authorized official:** NICKI MARIE MCDANIEL MPT (LEAD PT)
- **Authorized official phone:** (505) 699-5190

## Contact information

- **Practice address:** 530 NW 23RD AVE STE 116, PORTLAND, OR 97210-3287
- **Practice address phone:** (505) 699-5190
- **Mailing address:** 530 NW 23RD AVE STE 116, PORTLAND, OR 97210-3287
- **Mailing address phone:** (505) 699-5190

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 5138 | OR | Yes |

## Other

- **Enumeration date:** 03/24/2016
- **Last updated:** 03/24/2016