Organization
GB BODYWORK
Active
Organization
GB BODYWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENNADY BOLDETSKY (PRESIDENT)
(847) 366-9518
Entity
Organization
Contact information
Practice address
7975 N NORDICA AVE, NILES, IL 60714-3315
(847) 366-9518
Mailing address
7975 N NORDICA AVE, NILES, IL 60714-3315
(847) 366-9518
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
198001173
IL
Other
Enumeration date
06/03/2014
Last updated
06/03/2014
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