Provider Demographics
NPI:1477706679
Name:HEAD TO FITNESS, INC
Entity Type:Organization
Organization Name:HEAD TO FITNESS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NUTRITIONIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:V
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:CNC
Authorized Official - Phone:781-395-7640
Mailing Address - Street 1:78 SPRING STREET
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155
Mailing Address - Country:US
Mailing Address - Phone:781-395-7640
Mailing Address - Fax:781-395-7640
Practice Address - Street 1:78 SPRING ST.
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155
Practice Address - Country:US
Practice Address - Phone:781-395-7640
Practice Address - Fax:781-395-7640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-31
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty