Provider Demographics
NPI:1902566961
Name:JBFIT PT & WELLNESS, LLC
Entity Type:Organization
Organization Name:JBFIT PT & WELLNESS, LLC
Other - Org Name:JEN BAUER FITNESS, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:LDN
Authorized Official - Phone:267-246-0074
Mailing Address - Street 1:11344 BACK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BISHOPVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21813-1716
Mailing Address - Country:US
Mailing Address - Phone:267-246-0074
Mailing Address - Fax:
Practice Address - Street 1:11344 BACK CREEK RD
Practice Address - Street 2:
Practice Address - City:BISHOPVILLE
Practice Address - State:MD
Practice Address - Zip Code:21813-1716
Practice Address - Country:US
Practice Address - Phone:267-246-0074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-17
Last Update Date:2023-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty