| Organization Name: | FIT 4 LIFE SPORTS AND REHABILITATION, L.L.C. |
| NPI Number: | 1619378932 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CONNIE SUE HAYES (PRESIDENT/OWNER) |
| Mailing Address: | 210 Triad Ctr W O Fallon |
| State: | MO US |
| Postal Code: | 633667543 |
| Phone Number: | 6365424044 |
| Fax Number: | 6364891154 |
| NPI Enumeration Date: | 09/05/2014 |
| NPI Last Update Date: | 09/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 111N00000X |
| License Number: | 2002030437 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Chiropractic Providers |
| Taxonomy Classification: | Chiropractor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |