Provider Demographics
NPI:1053294314
Name:VITAL GRACE FITNESS LLC
Entity type:Organization
Organization Name:VITAL GRACE FITNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:865-680-7526
Mailing Address - Street 1:6700 BAUM DR STE 8
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-7334
Mailing Address - Country:US
Mailing Address - Phone:865-680-7526
Mailing Address - Fax:
Practice Address - Street 1:6700 BAUM DR STE 8
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-7334
Practice Address - Country:US
Practice Address - Phone:865-680-7526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty