MEDICARE: LIFEFITNESS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1033162748
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFEFITNESS, LLC

Provider Business Mailing Address
First Line	:	1 SISKIN PLZ
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37403-1306
Country	:	US
Telephone Number	:	423-634-1587
Fax Number	:	423-634-4587

Provider Business Practice Location Address
First Line	:	1 SISKIN PLZ
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37403-1306
Country	:	US
Telephone Number	:	423-634-1587
Fax Number	:	423-634-4587

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. TOD CAIN
Credential	:
Telephone Number	:	423-634-1648

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	05/14/2008

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Directions to “LIFEFITNESS, LLC ” Practice Location

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