NPI 1902217896

Custom Fitness LLC

Organisation Physical Therapy Clinic/Center Hagatna, GU

Practice location

Address: 588 West Marine Corps Dr STE 101, Hagatna, GU 96910
Phone: (671) 989-0436
Mailing address: PO Box 7372, Tamuning, GU 96931-7372

Authorised official

Name: Samantha Sablan
Title: President
Phone: (671) 989-0436

Registered specialties

Physical Therapy Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QP2000X Licence PT-106 (GU)

Other Clinic/Center providers in Guam →

Registry record

NPI: 1902217896
Entity type: Organization
NPI issued: 13 May 2014
Record last updated: 13 May 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.