Provider Demographics
NPI:1053593640
Name:ALL ABOUT THE FIT
Entity type:Organization
Organization Name:ALL ABOUT THE FIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-268-1777
Mailing Address - Street 1:PO BOX 17221
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72403-6722
Mailing Address - Country:US
Mailing Address - Phone:870-268-1777
Mailing Address - Fax:870-268-1777
Practice Address - Street 1:2213 E HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-6127
Practice Address - Country:US
Practice Address - Phone:870-268-1777
Practice Address - Fax:870-268-1777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5821200001Medicare NSC