Organization
CUSTOM FITNESS LLC
Active
Other names
CrossFit Gof Metgot
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA SABLAN (PRESIDENT)
(671) 989-0436
Entity
Organization
Contact information
Practice address
588 WEST MARINE CORPS DR STE 101, HAGATNA, GU 96910
(671) 989-0436
Mailing address
PO BOX 7372, TAMUNING, GU 96931-7372
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT-106
GU
Other
Enumeration date
05/13/2014
Last updated
05/13/2014
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