Organization
GRAVITY BODY FITNESS & STRUCTURAL ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD RICHARD CLARK SR. (FOUNDER / CEO)
(858) 232-3708
Entity
Organization
Contact information
Practice address
1050 E. RIVER ROAD, SUITE 200, TUCSON, AZ 85718
(520) 495-0438
Mailing address
1050 E. RIVER ROAD, SUITE 200, TUCSON, AZ 85718
(520) 495-0438
Taxonomy
Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
—
—
225700000X
Massage Therapist
Primary
447028-00
CA
Other
Enumeration date
08/22/2008
Last updated
08/22/2008
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