Provider Demographics
NPI:1932765807
Name:FITFXNRX PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:FITFXNRX PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:818-261-8511
Mailing Address - Street 1:23735 DEL MONTE DR UNIT 170
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-3376
Mailing Address - Country:US
Mailing Address - Phone:818-261-8511
Mailing Address - Fax:
Practice Address - Street 1:2750 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-3517
Practice Address - Country:US
Practice Address - Phone:818-261-8511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-15
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty