Provider Demographics
NPI:1023862729
Name:CORE FIT PHYSICAL THERAPY
Entity type:Organization
Organization Name:CORE FIT PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:ESCOTTO
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MS, MPT
Authorized Official - Phone:269-240-4272
Mailing Address - Street 1:2930 S NAPPANEE ST STE 1
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46517-1014
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2930 S NAPPANEE ST STE 1
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46517-1014
Practice Address - Country:US
Practice Address - Phone:574-584-3200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-17
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy