Provider Demographics
NPI:1023742350
Name:LIONS UNITED FITNESS CENTER
Entity type:Organization
Organization Name:LIONS UNITED FITNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LIFE COACH
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-348-7278
Mailing Address - Street 1:2535 PILOT KNOB RD STE 126
Mailing Address - Street 2:
Mailing Address - City:MENDOTA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55120-1170
Mailing Address - Country:US
Mailing Address - Phone:651-348-7278
Mailing Address - Fax:
Practice Address - Street 1:2535 PILOT KNOB RD STE 126
Practice Address - Street 2:
Practice Address - City:MENDOTA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55120-1170
Practice Address - Country:US
Practice Address - Phone:651-348-7278
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy