| Organization Name: | INTERSPORT FITNESS CENTER |
| NPI Number: | 1508140500 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LORETTA GARCIA LAUGHLIN (OWNER) |
| Mailing Address: | 4847 Stratos Way Modesto |
| State: | CA US |
| Postal Code: | 953569544 |
| Phone Number: | 2095229309 |
| Fax Number: | |
| NPI Enumeration Date: | 10/10/2011 |
| NPI Last Update Date: | 10/13/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174H00000X |
| License Number: | 164631 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Health Educator |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Health educators work in a variety of settings providing education to individuals or groups of individuals on healthy behaviors, wellness, and health-related topics with the goal of preventing diseases and health problems. Health educators generally require a bachelor |