Provider Demographics
NPI:1093041436
Name:FOREVER FIT OF STEAMBOAT SPRINGS
Entity Type:Organization
Organization Name:FOREVER FIT OF STEAMBOAT SPRINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWNELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPT
Authorized Official - Phone:970-870-3484
Mailing Address - Street 1:PO BOX 776056
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80477-6056
Mailing Address - Country:US
Mailing Address - Phone:970-870-3484
Mailing Address - Fax:970-879-5210
Practice Address - Street 1:1586 GRACELAND DR
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:CO
Practice Address - Zip Code:81623-2843
Practice Address - Country:US
Practice Address - Phone:970-846-8832
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO2162174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC531768Medicare PIN