Healthcare Provider Details

I. General information

NPI: 1972885960
Provider Name (Legal Business Name): 24/7 TOTAL FITNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2011
Last Update Date: 09/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31545 HIGHWAY 22
SPRINGFIELD LA
70462-7436
US

IV. Provider business mailing address

31545 HIGHWAY 22
SPRINGFIELD LA
70462-7436
US

V. Phone/Fax

Practice location:
  • Phone: 225-414-0228
  • Fax: 225-414-0228
Mailing address:
  • Phone: 225-414-0228
  • Fax: 225-414-0228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number000284
License Number StateLA

VIII. Authorized Official

Name: MR. ERNEST J. NAVARRE JR.
Title or Position: OWNER
Credential:
Phone: 225-414-0228