Healthcare Provider Details

I. General information

NPI: 1568893154
Provider Name (Legal Business Name): ERINS FITNESS CLUB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2013
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 W CYPRESS AVE SUITE E
BURBANK CA
91502-1742
US

IV. Provider business mailing address

150 W CYPRESS AVE SUITE E
BURBANK CA
91502-1742
US

V. Phone/Fax

Practice location:
  • Phone: 818-567-2257
  • Fax:
Mailing address:
  • Phone: 818-567-2257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number1006359
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number1006359
License Number StateCA

VIII. Authorized Official

Name: MRS. ERIN YEOMANS
Title or Position: FOUNDER/CEO
Credential:
Phone: 818-564-2257