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General NPI Number Information
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NPI Number | 1548506694
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Entity Type | Organization
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Legal Business Name | TRYM FITNESS LLC
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Dates
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Enumeration Date | 12/18/2012
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Last Update Date | 12/18/2012
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Provider Practice Location Address
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Address Line | 1400 W HEBRON PKWY
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City | CARROLLTON
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State | TX
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Zip | 75010-6515
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Country | US
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Telephone | 484-881-1702
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Fax |
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Provider Business Mailing Address
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Address Line | 6990 WINDHAVEN PKWY #218
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City | THE COLONY
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State | TX
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Zip | 75056-5204
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Country | US
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Telephone | 484-881-1702
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Fax |
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Authorized Official
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Title or Position | REGISTERED DIETITIAN, NUTRITIONIST
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Name | MR. TIMOTHY R MCCOMSEY
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Credential | R.D.
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Telephone | 484-881-1702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DT81945
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License Number State | TX
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