Provider Demographics
NPI:1871318428
Name:LEANFITRX LLC
Entity type:Organization
Organization Name:LEANFITRX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:251-599-0353
Mailing Address - Street 1:5 FRENCHMENS KY
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-8621
Mailing Address - Country:US
Mailing Address - Phone:251-599-0353
Mailing Address - Fax:
Practice Address - Street 1:930 S 4TH ST STE 209
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-6845
Practice Address - Country:US
Practice Address - Phone:251-599-0353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative MedicineGroup - Single Specialty