Provider Demographics
NPI:1093179947
Name:GYMFIT PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:GYMFIT PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:301-637-2574
Mailing Address - Street 1:150 POST OFFICE RD
Mailing Address - Street 2:2351
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20604-7599
Mailing Address - Country:US
Mailing Address - Phone:301-943-3613
Mailing Address - Fax:301-576-5043
Practice Address - Street 1:3317 PLAZA WAY
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4862
Practice Address - Country:US
Practice Address - Phone:301-637-2574
Practice Address - Fax:301-576-5043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-07
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy