Provider Demographics
NPI:1003352899
Name:FIT PHYSICAL THERAPY
Entity type:Organization
Organization Name:FIT PHYSICAL THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANOBILE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:303-409-2133
Mailing Address - Street 1:6612 S WARD ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-4855
Mailing Address - Country:US
Mailing Address - Phone:303-409-2133
Mailing Address - Fax:303-409-2233
Practice Address - Street 1:1555 DOVER ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-3105
Practice Address - Country:US
Practice Address - Phone:303-409-2133
Practice Address - Fax:303-409-2233
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIT PHYSICAL THERAPY PROF LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-17
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC492588Medicare PIN