# FIT KIDZ OBESITY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235461054
- **Authorized official:** MR. JAMES E KELLY (REGISTERED AGENT)
- **Authorized official phone:** (765) 430-4710

## Contact information

- **Practice address:** 2621 MAPLE POINT DR, LAFAYETTE, IN 47905-5159
- **Practice address phone:** (765) 430-4710
- **Mailing address:** 2621 MAPLE POINT DR, LAFAYETTE, IN 47905-5159

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | NULL | Yes |
| 305S00000X | Point of Service | — | NULL | — |

## Other

- **Enumeration date:** 02/03/2010
- **Last updated:** 02/03/2010