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General NPI Number Information
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NPI Number | 1659579092
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Entity Type | Organization
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Legal Business Name | GROWING UP FIT LLC
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Dates
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Enumeration Date | 07/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | GROWING UP FIT 120 VIA FORESTA LANE
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221
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Country | US
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Telephone | 716-818-8232
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Fax |
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Provider Business Mailing Address
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Address Line | GROWING UP FIT PO BOX 112
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City | EAST AMHERST
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State | NY
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Zip | 14051
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Country | US
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Telephone | 716-818-8232
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ANDREW RYAN
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Credential |
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Telephone | 716-579-3743
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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