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General NPI Number Information
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NPI Number | 1013642503
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Entity Type | Organization
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Legal Business Name | TRIFITNESS 247 LLC
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Dates
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Enumeration Date | 07/19/2022
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 2609 N BROADWAY ST STE A
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City | PITTSBURG
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State | KS
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Zip | 66762-2601
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Country | US
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Telephone | 620-404-5155
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Fax |
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Provider Business Mailing Address
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Address Line | 2609 N BROADWAY ST STE A
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City | PITTSBURG
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State | KS
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Zip | 66762-2601
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Country | US
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Telephone | 620-404-5155
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | HARRY BEEMAN
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Credential |
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Telephone | 918-440-3162
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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