Provider Demographics
NPI:1568893154
Name:ERINS FITNESS CLUB LLC
Entity Type:Organization
Organization Name:ERINS FITNESS CLUB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:YEOMANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-564-2257
Mailing Address - Street 1:150 W CYPRESS AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1742
Mailing Address - Country:US
Mailing Address - Phone:818-567-2257
Mailing Address - Fax:
Practice Address - Street 1:150 W CYPRESS AVE
Practice Address - Street 2:SUITE E
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1742
Practice Address - Country:US
Practice Address - Phone:818-567-2257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-06
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1006359261QP2000X
CA1006359261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation