Provider Demographics
NPI:1255749438
Name:FALCON THERAPY AND FITNESS LLC
Entity type:Organization
Organization Name:FALCON THERAPY AND FITNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SKOWRONSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:302-690-3925
Mailing Address - Street 1:4602 BIG ROCK DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-1004
Mailing Address - Country:US
Mailing Address - Phone:302-690-3925
Mailing Address - Fax:
Practice Address - Street 1:4602 BIG ROCK DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-1004
Practice Address - Country:US
Practice Address - Phone:302-690-3925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0002574261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy