Provider Demographics
NPI:1194492629
Name:SYNERGY FITNESS, LLC
Entity type:Organization
Organization Name:SYNERGY FITNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAUS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, AT, ATC, OPE-C
Authorized Official - Phone:906-228-7600
Mailing Address - Street 1:1414 W FAIR AVE STE 49
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-2675
Mailing Address - Country:US
Mailing Address - Phone:906-228-7600
Mailing Address - Fax:906-228-0110
Practice Address - Street 1:1414 W FAIR AVE STE 49
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-2675
Practice Address - Country:US
Practice Address - Phone:906-228-7600
Practice Address - Fax:906-228-0110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation