Healthcare Provider Details

I. General information

NPI: 1972976850
Provider Name (Legal Business Name): FITE HEALTH AND WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2015
Last Update Date: 11/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25185 LORAIN RD
NORTH OLMSTED OH
44070-2056
US

IV. Provider business mailing address

25185 LORAIN RD
NORTH OLMSTED OH
44070-2056
US

V. Phone/Fax

Practice location:
  • Phone: 440-777-2811
  • Fax: 440-777-2819
Mailing address:
  • Phone: 440-777-2811
  • Fax: 440-777-2819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAY-P FITE
Title or Position: CEO
Credential: DC
Phone: 440-777-2811