MEDICARE: FIT 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	225100000X	Physical Therapist	9529	AZ

General Provider Information

NPI Number	:	1710418835
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIT LLC

Provider Business Mailing Address
First Line	:	7318 N OPUNTA AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-6201
Country	:	US
Telephone Number	:	520-370-0770
Fax Number	:

Provider Business Practice Location Address
First Line	:	7318 N OPUNTA AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-6201
Country	:	US
Telephone Number	:	520-370-0770
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN-MARK BANTOCK
Credential	:
Telephone Number	:	520-370-0770

Provider Enumeration Date	:	03/21/2017
Last Update Date	:	03/21/2017

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Directions to “FIT LLC ” Practice Location

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