# HEALTHY BODY LLC

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

## Provider details

- **NPI number:** 1508389990
- **Authorized official:** MOLLIE MCDANIEL MOWERY NP-C (OWNER)
- **Authorized official phone:** (925) 518-6122

## Contact information

- **Practice address:** 2515 LADUE LN, FORT WAYNE, IN 46804-2796
- **Practice address phone:** (925) 518-6122
- **Mailing address:** 7619 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
- **Mailing address phone:** (260) 407-8006
- **Mailing address fax:** (260) 407-8006

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LG0600X | Gerontology Nurse Practitioner | 71006194A | IN | Yes |

## Other

- **Enumeration date:** 07/18/2017
- **Last updated:** 07/18/2017