Organization
BODY MECHANIX, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMIE NGUYEN KAMON-BRANCAZIO DPT (OWNER/PRESIDENT)
(928) 680-2639
Entity
Organization
Contact information
Practice address
1695 MESQUITE AVE, SUITE 106, LAKE HAVASU CITY, AZ 86403-5678
(928) 680-2639
(928) 680-2626
Mailing address
1695 MESQUITE AVE, SUITE 106, LAKE HAVASU CITY, AZ 86403-5678
(928) 680-2639
(928) 680-2626
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
6192
AZ
Other
Enumeration date
05/02/2008
Last updated
07/01/2008
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