Provider Demographics
NPI:1982210563
Name:VROK FITNESS LLC
Entity Type:Organization
Organization Name:VROK FITNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYLIE
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:CPT
Authorized Official - Phone:813-451-4466
Mailing Address - Street 1:PO BOX 2534
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-0010
Mailing Address - Country:US
Mailing Address - Phone:813-451-4466
Mailing Address - Fax:
Practice Address - Street 1:631 OAKSIDE PL
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30102-8813
Practice Address - Country:US
Practice Address - Phone:813-451-4466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-19
Last Update Date:2020-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty