Provider Demographics
NPI:1881987956
Name:VALHALLA HEALTH & FITNESS CLUB
Entity type:Organization
Organization Name:VALHALLA HEALTH & FITNESS CLUB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SALES/MARKETING DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:STILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MS HEALTH CARE ADM
Authorized Official - Phone:610-779-6006
Mailing Address - Street 1:4970 DEMOSS RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-9039
Mailing Address - Country:US
Mailing Address - Phone:610-779-6006
Mailing Address - Fax:610-779-6008
Practice Address - Street 1:4970 DEMOSS RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-9039
Practice Address - Country:US
Practice Address - Phone:610-779-6006
Practice Address - Fax:610-779-6008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty