Organization
BODYWORX PHYSICAL THERAPY & CHIROPRACTIC WELLNESS CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRAD LEE PROFITT PT, DPT, CSCS, DC (DOCTOR PRESIDENT)
(606) 836-6683
Entity
Organization
Contact information
Practice address
1451 DIEDERICH BLVD, RUSSELL, KY 41169-1718
(606) 833-2173
Mailing address
1451 DIEDERICH BLVD, RUSSELL, KY 41169-1718
(606) 836-6683
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
4634
KY
225100000X
Physical Therapist
Primary
005907
KY
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1188596
CHA PROVIDER NUMBER
KY
05
—
85001501
—
KY
05
—
85900272
—
KY
Enumeration date
01/22/2007
Last updated
09/25/2023
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