Healthcare Provider Details

I. General information

NPI: 1730559428
Provider Name (Legal Business Name): TNT FITNESS TRAINING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2015
Last Update Date: 10/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1022 DUMESNIL ST
LOUISVILLE KY
40210-1517
US

IV. Provider business mailing address

1022 DUMESNIL ST
LOUISVILLE KY
40210-1517
US

V. Phone/Fax

Practice location:
  • Phone: 502-931-3834
  • Fax: 502-637-5911
Mailing address:
  • Phone: 502-931-3834
  • Fax: 502-637-5911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number039048
License Number StateKY

VIII. Authorized Official

Name: MS. TANIKA L OWENS
Title or Position: PERSONAL TRAINER/OWNER
Credential: MS, NSCA-CPT
Phone: 502-931-3834