Provider Demographics
NPI:1275921975
Name:UNDENIABLY FIT, LLC
Entity Type:Organization
Organization Name:UNDENIABLY FIT, LLC
Other - Org Name:UFIT THRIVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-209-9943
Mailing Address - Street 1:171 TECHNOLOGY DR
Mailing Address - Street 2:SUITE 700
Mailing Address - City:BOALSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16827-1635
Mailing Address - Country:US
Mailing Address - Phone:323-209-9943
Mailing Address - Fax:
Practice Address - Street 1:171 TECHNOLOGY DR
Practice Address - Street 2:SUITE 700
Practice Address - City:BOALSBURG
Practice Address - State:PA
Practice Address - Zip Code:16827-1635
Practice Address - Country:US
Practice Address - Phone:323-209-9943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-03
Last Update Date:2015-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service