MEDICARE: FIT U HEALTH, 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	174H00000X	Health Educator

General Provider Information

NPI Number	:	1508135096
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIT U HEALTH, LLC

Provider Business Mailing Address
First Line	:	PO BOX 1426
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37024-1426
Country	:	US
Telephone Number	:	615-480-7447
Fax Number	:

Provider Business Practice Location Address
First Line	:	3500 N MOUNT JULIET RD
Second Line	:
City	:	MOUNT JULIET
State	:	TN
Zip	:	37122-3078
Country	:	US
Telephone Number	:	615-480-7447
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. JOHN D MZY
Credential	:
Telephone Number	:	615-480-7447

Provider Enumeration Date	:	12/29/2011
Last Update Date	:	12/29/2011

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