Provider Demographics
NPI:1619634771
Name:GMS THERAPY AND FITNESS LLC
Entity Type:Organization
Organization Name:GMS THERAPY AND FITNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:FANNIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:937-269-5288
Mailing Address - Street 1:579 IRISHROSE LN
Mailing Address - Street 2:
Mailing Address - City:PARK HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41011-2850
Mailing Address - Country:US
Mailing Address - Phone:937-269-5288
Mailing Address - Fax:
Practice Address - Street 1:579 IRISHROSE LN
Practice Address - Street 2:
Practice Address - City:PARK HILLS
Practice Address - State:KY
Practice Address - Zip Code:41011-2850
Practice Address - Country:US
Practice Address - Phone:937-269-5288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty