Provider Demographics
NPI:1861665143
Name:PREMIER FITNESS, INC.
Entity Type:Organization
Organization Name:PREMIER FITNESS, INC.
Other - Org Name:PREMIER FITNESS STUDIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:HARTWIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-735-9653
Mailing Address - Street 1:3100 WOODBURY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-9600
Mailing Address - Country:US
Mailing Address - Phone:651-735-9653
Mailing Address - Fax:651-735-0238
Practice Address - Street 1:3100 WOODBURY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55129-9600
Practice Address - Country:US
Practice Address - Phone:651-735-9653
Practice Address - Fax:651-735-0238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty