Provider Demographics
NPI:1174850135
Name:LETS GET PHYSICAL, LLC
Entity Type:Organization
Organization Name:LETS GET PHYSICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BETSI
Authorized Official - Middle Name:L
Authorized Official - Last Name:SANTONE
Authorized Official - Suffix:
Authorized Official - Credentials:NUTRITION & WELLNESS
Authorized Official - Phone:843-438-4470
Mailing Address - Street 1:694 JAMESTOWN DR
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:SC
Mailing Address - Zip Code:29576
Mailing Address - Country:US
Mailing Address - Phone:843-438-4470
Mailing Address - Fax:843-492-7741
Practice Address - Street 1:694 JAMESTOWN DR
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:SC
Practice Address - Zip Code:29576
Practice Address - Country:US
Practice Address - Phone:843-438-4470
Practice Address - Fax:843-492-7741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ63465133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty