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General NPI Number Information
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NPI Number | 1730911249
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Entity Type | Organization
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Legal Business Name | EVERFLEXFIT LLC
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Dates
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Enumeration Date | 08/14/2024
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 51 A ST
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City | LAKE LOTAWANA
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State | MO
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Zip | 64086-9703
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Country | US
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Telephone | 816-289-1502
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Fax |
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Provider Business Mailing Address
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Address Line | 51 A ST
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City | LAKE LOTAWANA
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State | MO
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Zip | 64086-9703
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Country | US
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Telephone | 816-289-1502
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | BRANT GARRISON
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Credential | BS, CSS, CPT, CSF CN
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Telephone | 816-289-1502
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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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