Provider Demographics
NPI:1164583977
Name:ACCELERATED SPORTS THERAPY & FITNESS, INC.
Entity Type:Organization
Organization Name:ACCELERATED SPORTS THERAPY & FITNESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:SELL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:763-228-2467
Mailing Address - Street 1:PO BOX 47035
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-0035
Mailing Address - Country:US
Mailing Address - Phone:763-228-2467
Mailing Address - Fax:
Practice Address - Street 1:14100 CARLSON PKWY # 200
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-5302
Practice Address - Country:US
Practice Address - Phone:763-519-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty