# BODY LISTENER LLC

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

## Provider details

- **NPI number:** 1477147155
- **Authorized official:** GRANT M HEADLEY DPT (OWNER)
- **Authorized official phone:** (503) 568-1136

## Contact information

- **Practice address:** 460 2ND ST, LAKE OSWEGO, OR 97034-3257
- **Practice address phone:** (503) 568-1136
- **Practice address fax:** (503) 213-9729
- **Mailing address:** PO BOX 991, LAKE OSWEGO, OR 97034-0110
- **Mailing address phone:** (503) 568-1136
- **Mailing address fax:** (503) 213-9729

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 02/24/2021
- **Last updated:** 04/01/2021