| Organization Name: | FITNESS FOCUS, INC. |
| NPI Number: | 1720156680 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHANNON DEE MAIXNER (OWNER - PHYSICAL THERAPIST) |
| Mailing Address: | 688 Wildwood Road Mahtomedi |
| State: | MN US |
| Postal Code: | 551152060 |
| Phone Number: | 6514299947 |
| Fax Number: | 6514291029 |
| NPI Enumeration Date: | 11/30/2006 |
| NPI Last Update Date: | 03/29/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 4723 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |