Provider Demographics
NPI:1578035630
Name:PREMIER FITNESS SYSTEMS LLC
Entity Type:Organization
Organization Name:PREMIER FITNESS SYSTEMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-421-1969
Mailing Address - Street 1:7267 E ADOBE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-4032
Mailing Address - Country:US
Mailing Address - Phone:212-421-1969
Mailing Address - Fax:212-223-0198
Practice Address - Street 1:7267 E ADOBE DR STE 101
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4032
Practice Address - Country:US
Practice Address - Phone:212-421-1969
Practice Address - Fax:212-223-0198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty