Provider Demographics
NPI:1215451471
Name:FITNESS QUEST-ELLENTON, LLC
Entity type:Organization
Organization Name:FITNESS QUEST-ELLENTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MACKENZIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTRUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-721-9100
Mailing Address - Street 1:3657 CORTEZ RD W STE 110
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-3171
Mailing Address - Country:US
Mailing Address - Phone:941-721-9100
Mailing Address - Fax:941-721-9119
Practice Address - Street 1:8175 US HIGHWAY 301 N
Practice Address - Street 2:
Practice Address - City:PARRISH
Practice Address - State:FL
Practice Address - Zip Code:34219-8669
Practice Address - Country:US
Practice Address - Phone:941-721-9100
Practice Address - Fax:866-721-4334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-31
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy