Provider Demographics
NPI:1760670426
Name:FIT 4 GOLF, LLC DBA ADVANCED PHYSICAL THERAPY AND MASSAGE
Entity Type:Organization
Organization Name:FIT 4 GOLF, LLC DBA ADVANCED PHYSICAL THERAPY AND MASSAGE
Other - Org Name:ADVANCED PHYSICAL THERAPY AND MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:BRANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:319-350-9616
Mailing Address - Street 1:359 N 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-3618
Mailing Address - Country:US
Mailing Address - Phone:319-350-9616
Mailing Address - Fax:319-624-5273
Practice Address - Street 1:359 N 1ST AVE
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-3618
Practice Address - Country:US
Practice Address - Phone:319-350-9616
Practice Address - Fax:319-624-5273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy