Provider Demographics
NPI:1467693705
Name:ADAPTIVE ATTITUDES IN FITNESS, INC
Entity Type:Organization
Organization Name:ADAPTIVE ATTITUDES IN FITNESS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:G
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:NMD
Authorized Official - Phone:678-493-2597
Mailing Address - Street 1:1480 HICKORY ST.
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115
Mailing Address - Country:US
Mailing Address - Phone:678-493-2597
Mailing Address - Fax:678-493-2598
Practice Address - Street 1:1480 HICKORY ST.
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115
Practice Address - Country:US
Practice Address - Phone:678-493-2597
Practice Address - Fax:678-493-2598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNAT1000288175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty