Organization
BOD SQUAD, LLC, THE
Active
Other names
BOD SQUAD, THE
Organization subpart
No
Provider details
NPI number
Authorized official
DAIVD STALLINGS JENSEN MSPT (OWNER)
(801) 400-1834
Entity
Organization
Contact information
Practice address
1803 ABBEDALE LN, SANDY, UT 84092-3847
(801) 754-1619
(866) 764-1145
Mailing address
1803 ABBEDALE LN, SANDY, UT 84092-3847
(801) 400-1834
(866) 764-1145
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6342141-0144
UT
332B00000X
Durable Medical Equipment & Medical Supplies
6342141-0144
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03328412405-001
BCBS
—
Enumeration date
06/09/2009
Last updated
10/09/2015
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