Provider Demographics
NPI:1295095164
Name:ULTIMATE FAMILY FITNESS
Entity type:Organization
Organization Name:ULTIMATE FAMILY FITNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:BENNETT
Authorized Official - Last Name:BARTELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-813-0800
Mailing Address - Street 1:2719 N US HIGHWAY 75
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-2567
Mailing Address - Country:US
Mailing Address - Phone:903-813-0800
Mailing Address - Fax:903-893-4937
Practice Address - Street 1:2719 N US HIGHWAY 75
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2567
Practice Address - Country:US
Practice Address - Phone:903-813-0800
Practice Address - Fax:903-893-4937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1069722225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty