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General NPI Number Information
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NPI Number | 1467214601
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Entity Type | Organization
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Legal Business Name | SMART FIT BY BRIAN , LLC
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Dates
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Enumeration Date | 01/24/2024
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 2204 FOUNTAIN SQ
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City | SNELLVILLE
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State | GA
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Zip | 30078-5757
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Country | US
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Telephone | 470-331-8658
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Fax | 888-284-1971
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Provider Business Mailing Address
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Address Line | 2100 RIVERSIDE PKWY STE 128-144
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-5927
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Country | US
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Telephone | 470-331-8658
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRIAN JAMAL MEADOWS
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Credential |
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Telephone | 470-331-8658
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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