Provider Demographics
NPI:1982020327
Name:MIGHTY FIT LLC
Entity Type:Organization
Organization Name:MIGHTY FIT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-385-1620
Mailing Address - Street 1:628 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-3501
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14757 OAK RD
Practice Address - Street 2:200
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-8178
Practice Address - Country:US
Practice Address - Phone:317-385-1620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty