Healthcare Provider Details

I. General information

NPI: 1235368127
Provider Name (Legal Business Name): CORPORATE FITNESS TRAINERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2009
Last Update Date: 07/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 PEACHTREE ST STE 1800
ATLANTA GA
30309-3574
US

IV. Provider business mailing address

1230 PEACHTREE ST STE 1800
ATLANTA GA
30309-3574
US

V. Phone/Fax

Practice location:
  • Phone: 404-538-4945
  • Fax:
Mailing address:
  • Phone: 404-538-4945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateGA

VIII. Authorized Official

Name: ERIC ALLEN
Title or Position: CEO
Credential:
Phone: 404-538-4945