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General NPI Number Information
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NPI Number | 1043927213
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Entity Type | Organization
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Legal Business Name | UNLIMITED RESTARTS FITNESS LLC
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Dates
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Enumeration Date | 10/27/2022
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 1040 WATERCOURSE CIR APT 204
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City | GRAHAM
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State | NC
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Zip | 27253-3191
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Country | US
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Telephone | 336-521-3068
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Fax |
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Provider Business Mailing Address
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Address Line | 1040 WATERCOURSE CIR APT 204
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City | GRAHAM
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State | NC
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Zip | 27253-3191
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Country | US
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Telephone | 336-521-3068
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Fax |
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Authorized Official
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Title or Position | NUTRITION COACH
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Name | CHEIWANDA JONES
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Credential | CMA
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Telephone | 336-521-3068
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343800000X
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Taxonomy Name | Secured Medical Transport (VAN)
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License Number |
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License Number State |
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