Provider Demographics
NPI:1366488272
Name:INNERFIT, INC.
Entity type:Organization
Organization Name:INNERFIT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:
Authorized Official - Last Name:DUGGAR
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:334-396-1400
Mailing Address - Street 1:7088 UNIVERSITY CT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-6992
Mailing Address - Country:US
Mailing Address - Phone:334-396-1400
Mailing Address - Fax:334-396-2727
Practice Address - Street 1:7088 UNIVERSITY CT
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-6992
Practice Address - Country:US
Practice Address - Phone:334-396-1400
Practice Address - Fax:334-396-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL01-6572Medicare ID - Type UnspecifiedFACILITY PROVIDER #