Provider Demographics
NPI:1770065369
Name:SLIM FIT WEIGHT LOSS MECICAL CLINIC AND SPA CORPORATION
Entity type:Organization
Organization Name:SLIM FIT WEIGHT LOSS MECICAL CLINIC AND SPA CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZSA ZSA
Authorized Official - Middle Name:
Authorized Official - Last Name:COUCH
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGER
Authorized Official - Phone:334-450-7758
Mailing Address - Street 1:2567 BELL RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-4369
Mailing Address - Country:US
Mailing Address - Phone:334-450-7758
Mailing Address - Fax:
Practice Address - Street 1:2567 BELL RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-4369
Practice Address - Country:US
Practice Address - Phone:334-450-7758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service