Provider Demographics
NPI:1023848124
Name:CROSSFIT POLARIS PHYSICAL THERAPY
Entity type:Organization
Organization Name:CROSSFIT POLARIS PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:KRESS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:614-371-8769
Mailing Address - Street 1:8692 OLDE WORTHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-8987
Mailing Address - Country:US
Mailing Address - Phone:614-371-8769
Mailing Address - Fax:
Practice Address - Street 1:8692 OLDE WORTHINGTON RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-8987
Practice Address - Country:US
Practice Address - Phone:614-371-8769
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-03
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy