Provider Demographics
NPI:1003432527
Name:ATW DIETITIAN, LLC
Entity Type:Organization
Organization Name:ATW DIETITIAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WIENSCH-THURNAU
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:540-421-9802
Mailing Address - Street 1:PO BOX 404
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22803-0404
Mailing Address - Country:US
Mailing Address - Phone:540-421-9802
Mailing Address - Fax:
Practice Address - Street 1:360 MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-1823
Practice Address - Country:US
Practice Address - Phone:540-421-9802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-20
Last Update Date:2020-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty