Provider Demographics
NPI:1407315336
Name:GYMFIT HEALTH NETWORK, LLC
Entity type:Organization
Organization Name:GYMFIT HEALTH NETWORK, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-943-9479
Mailing Address - Street 1:34 SHINING WILLOW WAY UNIT 307
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-4224
Mailing Address - Country:US
Mailing Address - Phone:301-818-5527
Mailing Address - Fax:240-913-9223
Practice Address - Street 1:3317 PLAZA WAY
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4862
Practice Address - Country:US
Practice Address - Phone:301-818-5527
Practice Address - Fax:240-913-9223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-19
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD184058400Medicaid