Provider Demographics
NPI:1992256671
Name:SYNERGY FITNESS & WELLNESS CENTER LLC
Entity type:Organization
Organization Name:SYNERGY FITNESS & WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:O'ROURKE-BARR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:340-714-2348
Mailing Address - Street 1:6115 ESTATE SMITH BAY
Mailing Address - Street 2:SUITE 334-335, BOX 5
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-1324
Mailing Address - Country:US
Mailing Address - Phone:340-714-2348
Mailing Address - Fax:
Practice Address - Street 1:6115 ESTATE SMITH BAY
Practice Address - Street 2:SUITE 334-335, BOX 5
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-1324
Practice Address - Country:US
Practice Address - Phone:340-714-2348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health