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General NPI Number Information
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NPI Number | 1063782274
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Entity Type | Organization
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Legal Business Name | FIT-RX
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Dates
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Enumeration Date | 01/04/2012
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Last Update Date | 02/19/2015
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Provider Practice Location Address
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Address Line | 620 CHURCH ST E
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City | BRENTWOOD
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State | TN
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Zip | 37027-5284
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Country | US
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Telephone | 615-732-1840
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Fax | 615-807-3250
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Provider Business Mailing Address
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Address Line | 115 PENN WARREN DR STE 300-280
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City | BRENTWOOD
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State | TN
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Zip | 37027-5047
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Country | US
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Telephone | 615-727-8387
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Fax | 615-457-8094
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Authorized Official
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Title or Position | CHAIRMAN
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Name | MICHAEL CARTWRIGHT
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Credential |
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Telephone | 615-727-8387
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | I000000010097
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License Number State | TN
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