Organization
BODY THERAPY SHOP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICKY CUMMINGS (OWNER)
(217) 531-8287
Entity
Organization
Contact information
Practice address
300 S BROADWAY AVE, URBANA, IL 61801-3302
(217) 531-8287
Mailing address
300 S BROADWAY AVE, URBANA, IL 61801-3302
(217) 531-8287
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/18/2008
Last updated
07/18/2008
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