Provider Demographics
NPI:1801337563
Name:FIT PHYSICAL THERAPY AND CONSULTING SERVICES, LLC
Entity type:Organization
Organization Name:FIT PHYSICAL THERAPY AND CONSULTING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:CYR
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:207-944-7020
Mailing Address - Street 1:11 HAMEL LN
Mailing Address - Street 2:
Mailing Address - City:OLD TOWN
Mailing Address - State:ME
Mailing Address - Zip Code:04468-1949
Mailing Address - Country:US
Mailing Address - Phone:207-944-7020
Mailing Address - Fax:
Practice Address - Street 1:11 HAMEL LN
Practice Address - Street 2:
Practice Address - City:OLD TOWN
Practice Address - State:ME
Practice Address - Zip Code:04468-1949
Practice Address - Country:US
Practice Address - Phone:207-944-7020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty