| Fit4 An Empowered Life Llc | |
|
4802 E Ray Rd Ste 23-266 Phoenix AZ 85044-6405 | |
| (313) 590-5253 | |
| (602) 491-2677 |
| Full Name | Fit4 An Empowered Life Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4802 E Ray Rd Ste 23-266, Phoenix, Arizona |
| Authorized Official Name and Position | Lajuana E Mitchell (OWNER) |
| Authorized Official Contact | 3135905253 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fit4 An Empowered Life Llc 4802 E Ray Rd Suite 23-266 Phoenix AZ 85076-1492 Ph: (313) 590-5253 | Fit4 An Empowered Life Llc 4802 E Ray Rd Ste 23-266 Phoenix AZ 85044-6405 Ph: (313) 590-5253 |
| NPI Number | 1922624220 |
|---|---|
| Provider Enumeration Date | 06/23/2020 |
| Last Update Date | 03/30/2021 |
| Certification Date | 03/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922624220 | NPI | - | NPPES |
| 277387 | Medicaid | AZ | |
| 23098837 | Other | AZ | ENTITY ID |
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