Organization
BODY SHAPE MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH BATES MD (MEDICAL DIRECTOR)
(502) 638-4906
Entity
Organization
Contact information
Practice address
4211 SPRINGHURST BLVD, LOUISVILLE, KY 40241-6161
(502) 638-4906
Mailing address
4211 SPRINGHURST BLVD, LOUISVILLE, KY 40241-6161
(502) 638-4906
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
3009403
KY
Other
Enumeration date
06/16/2015
Last updated
06/16/2015
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