Provider Demographics
NPI:1912409871
Name:ONWARD PERSONAL TRAINING LLC
Entity Type:Organization
Organization Name:ONWARD PERSONAL TRAINING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:DUDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-792-3633
Mailing Address - Street 1:3250 W BIG BEAVER RD STE 300A
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-2900
Mailing Address - Country:US
Mailing Address - Phone:248-792-3633
Mailing Address - Fax:248-281-0515
Practice Address - Street 1:3250 W BIG BEAVER RD STE 228
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084
Practice Address - Country:US
Practice Address - Phone:248-792-3633
Practice Address - Fax:248-281-0515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-06
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation TherapistGroup - Single Specialty