Organization
BODY FOR LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE DIAZ (MEMBER)
(901) 373-3300
Entity
Organization
Contact information
Practice address
8099 STAGE HILLS BLVD STE 101, BARTLETT, TN 38133-4064
(901) 373-3300
(901) 373-3303
Mailing address
8099 STAGE HILLS BLVD STE 101, BARTLETT, TN 38133-4064
(901) 373-3300
(901) 373-3303
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APN12232
TN
Other
Enumeration date
06/20/2011
Last updated
04/20/2020
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