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General NPI Number Information
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NPI Number | 1063018364
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Entity Type | Organization
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Legal Business Name | SURMOUNT FITNESS AND PERFORMANCE
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Dates
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Enumeration Date | 12/10/2020
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Last Update Date | 12/26/2022
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Provider Practice Location Address
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Address Line | 7051 YANKEE RD
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City | LIBERTY TOWNSHIP
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State | OH
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Zip | 45044-9132
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Country | US
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Telephone | 513-445-8524
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Fax |
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Provider Business Mailing Address
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Address Line | 804 LORY LN
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City | CINCINNATI
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State | OH
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Zip | 45215-4941
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Country | US
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Telephone | 708-567-2359
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | BRIAN EDWARD BARNEY
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Credential | PT, DPT, CSCS
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Telephone | 708-567-2359
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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