Provider Demographics
NPI:1427649482
Name:LIFE CHANGES FITNESS, INC
Entity type:Organization
Organization Name:LIFE CHANGES FITNESS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:AKERS
Authorized Official - Suffix:
Authorized Official - Credentials:DM
Authorized Official - Phone:765-603-8112
Mailing Address - Street 1:726 S LINCOLN BLVD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46953-2524
Mailing Address - Country:US
Mailing Address - Phone:765-664-4742
Mailing Address - Fax:
Practice Address - Street 1:1107 N FOREST AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-1823
Practice Address - Country:US
Practice Address - Phone:765-664-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy