Provider Demographics
NPI:1730315235
Name:B FIT 4 LIFE, INC
Entity Type:Organization
Organization Name:B FIT 4 LIFE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:KITCHEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-496-4386
Mailing Address - Street 1:6825 JIMMY CARTER BLVD
Mailing Address - Street 2:1800
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071
Mailing Address - Country:US
Mailing Address - Phone:404-496-4386
Mailing Address - Fax:404-963-0503
Practice Address - Street 1:6825 JIMMY CARTER BLVD
Practice Address - Street 2:SUITE1800
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-1228
Practice Address - Country:US
Practice Address - Phone:404-496-4386
Practice Address - Fax:404-963-0503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133NN1002X
GA036409207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty