Provider Demographics
NPI:1467590224
Name:PROFESSIONAL FITNESS TRAINING ASSOCIATES LLC
Entity Type:Organization
Organization Name:PROFESSIONAL FITNESS TRAINING ASSOCIATES LLC
Other - Org Name:PFTMOBILE
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:JEANEEN
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-638-6277
Mailing Address - Street 1:1168 E BROAD ST APT H3
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-1328
Mailing Address - Country:US
Mailing Address - Phone:614-448-9893
Mailing Address - Fax:603-462-2316
Practice Address - Street 1:1168 E BROAD ST APT H3
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-1328
Practice Address - Country:US
Practice Address - Phone:614-448-9893
Practice Address - Fax:603-462-2316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health