Provider Demographics
NPI:1861885642
Name:PREMIER RUNNING, LLC
Entity type:Organization
Organization Name:PREMIER RUNNING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCHWEITZER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:727-442-7500
Mailing Address - Street 1:PO BOX 5021
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33758-5021
Mailing Address - Country:US
Mailing Address - Phone:727-442-7500
Mailing Address - Fax:727-442-7522
Practice Address - Street 1:6986 22ND AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-3920
Practice Address - Country:US
Practice Address - Phone:727-442-7500
Practice Address - Fax:727-442-7522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19898225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty