Provider Demographics
NPI:1962952556
Name:FITNESS QUEST - PALMER RANCH, LLC
Entity type:Organization
Organization Name:FITNESS QUEST - PALMER RANCH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MACKENZIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARTRUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-361-9020
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:941-361-9020
Mailing Address - Fax:941-217-4038
Practice Address - Street 1:8588 POTTER PARK DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-5471
Practice Address - Country:US
Practice Address - Phone:941-361-9020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-07
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty