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General NPI Number Information
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NPI Number | 1194492629
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Entity Type | Organization
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Legal Business Name | SYNERGY FITNESS, LLC
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Dates
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Enumeration Date | 08/24/2021
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Last Update Date | 08/24/2021
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Provider Practice Location Address
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Address Line | 1414 W FAIR AVE STE 49
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City | MARQUETTE
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State | MI
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Zip | 49855-2675
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Country | US
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Telephone | 906-228-7600
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Fax | 906-228-0110
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Provider Business Mailing Address
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Address Line | 1414 W FAIR AVE STE 49
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City | MARQUETTE
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State | MI
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Zip | 49855-2675
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Country | US
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Telephone | 906-228-7600
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Fax | 906-228-0110
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Authorized Official
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Title or Position | OWNER, DIRECTOR
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Name | BRIAN CLAUS
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Credential | MS, AT, ATC, OPE-C
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Telephone | 906-228-7600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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