Provider Demographics
NPI:1194167486
Name:FIT PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:FIT PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:FRATER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:214-494-4643
Mailing Address - Street 1:279 MAIN ST STE 114
Mailing Address - Street 2:SUITE 114
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4307
Mailing Address - Country:US
Mailing Address - Phone:214-494-4643
Mailing Address - Fax:214-494-4654
Practice Address - Street 1:279 MAIN ST STE 114
Practice Address - Street 2:SUITE 114
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4307
Practice Address - Country:US
Practice Address - Phone:214-494-4643
Practice Address - Fax:214-494-4654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-27
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1155693261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy