Provider Demographics
NPI:1073994984
Name:TNT KID'S FITNESS
Entity Type:Organization
Organization Name:TNT KID'S FITNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING/HUMAN RESOURCES BENEFITS
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:KARLSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-365-8868
Mailing Address - Street 1:2800 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-6811
Mailing Address - Country:US
Mailing Address - Phone:701-365-8868
Mailing Address - Fax:701-365-8870
Practice Address - Street 1:2800 MAIN AVE
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6811
Practice Address - Country:US
Practice Address - Phone:701-365-8868
Practice Address - Fax:701-365-8870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty