# BODY DYNAMIX INTEGRATED SPORTS MEDICINE, INC

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

## Provider details

- **NPI number:** 1912386376
- **Authorized official:** ERIN DAIGLE (BILLING MANAGER)
- **Authorized official phone:** (818) 706-9435

## Contact information

- **Practice address:** 18344 OXNARD STREET, UNIT 104, TARZANA, CA 91356
- **Practice address phone:** (818) 783-4085
- **Practice address fax:** (818) 783-4065
- **Mailing address:** 18344 OXNARD STREET, UNIT 104, TARZANA, CA 91356
- **Mailing address phone:** (818) 783-4085
- **Mailing address fax:** (818) 783-4065

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NR0400X | Rehabilitation Chiropractor | — | NULL | — |
| 111NR0400X | Rehabilitation Chiropractor | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | CA | Yes |

## Other

- **Enumeration date:** 05/19/2015
- **Last updated:** 07/21/2022