Provider Demographics
NPI:1316278757
Name:YOUR TOP PERSONAL TRAINER
Entity type:Organization
Organization Name:YOUR TOP PERSONAL TRAINER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFICATION
Authorized Official - Phone:832-451-4419
Mailing Address - Street 1:1015 COUNTRY PLACE DR
Mailing Address - Street 2:121
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-4779
Mailing Address - Country:US
Mailing Address - Phone:832-451-4419
Mailing Address - Fax:
Practice Address - Street 1:1015 COUNTRY PLACE DR
Practice Address - Street 2:121
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-4779
Practice Address - Country:US
Practice Address - Phone:832-451-4437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-25
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services