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General NPI Number Information
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NPI Number | 1699571158
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Entity Type | Organization
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Legal Business Name | CLINTON FITNESS INC
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 20596 HALL RD
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-5326
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Country | US
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Telephone | 586-263-6600
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Fax |
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Provider Business Mailing Address
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Address Line | 20596 HALL RD
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-5326
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Country | US
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Telephone | 586-263-6600
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MICHAEL NEGENDANK
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Credential |
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Telephone | 586-263-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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