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General NPI Number Information
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NPI Number | 1083266381
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Entity Type | Organization
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Legal Business Name | GET INTO SHAPE MD
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Dates
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Enumeration Date | 07/16/2019
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Last Update Date | 07/16/2019
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Provider Practice Location Address
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Address Line | 5803 LEE HWY STE 101
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City | CHATTANOOGA
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State | TN
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Zip | 37421-3547
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Country | US
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Telephone | 423-541-2438
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Fax | 423-541-2984
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Provider Business Mailing Address
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Address Line | 5803 LEE HWY STE 101
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City | CHATTANOOGA
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State | TN
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Zip | 37421-3547
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Country | US
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Telephone | 423-541-2438
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Fax | 423-541-2984
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Authorized Official
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Title or Position | OWNER
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Name | CASEY SHARP
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Credential | CCMA, RMA
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Telephone | 423-541-2438
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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