Provider Demographics
NPI:1003454893
Name:FIRST FIT SPORTS PERFORMANCE
Entity Type:Organization
Organization Name:FIRST FIT SPORTS PERFORMANCE
Other - Org Name:FIRST FIT SPORTS PERFORMANCE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:LUEKING
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:505-231-2290
Mailing Address - Street 1:11446 LEDBURY WAY
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-5577
Mailing Address - Country:US
Mailing Address - Phone:505-231-2290
Mailing Address - Fax:
Practice Address - Street 1:40 W GUDE DR STE 240
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1152
Practice Address - Country:US
Practice Address - Phone:505-231-2290
Practice Address - Fax:443-422-6765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-12
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy