Healthcare Provider Details

I. General information

NPI: 1295671592
Provider Name (Legal Business Name): INTELLIGENT QUANTIFIED FITNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 NE ATLANTIC ST
TULLAHOMA TN
37388-3575
US

IV. Provider business mailing address

PO BOX 170
TULLAHOMA TN
37388-0170
US

V. Phone/Fax

Practice location:
  • Phone: 931-247-9779
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN S SMITH
Title or Position: OWNER/DIRECTOR
Credential: CPT
Phone: 931-247-9779