Provider Demographics
NPI:1013535947
Name:THREE RIVERS NUTRITION AND DIETIETICS
Entity Type:Organization
Organization Name:THREE RIVERS NUTRITION AND DIETIETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZURCHIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN, LDN
Authorized Official - Phone:412-526-6398
Mailing Address - Street 1:3062 SUN DEW LN
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-7344
Mailing Address - Country:US
Mailing Address - Phone:412-526-6398
Mailing Address - Fax:
Practice Address - Street 1:3731 EQUESTRIAN LN APT 202B
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-5660
Practice Address - Country:US
Practice Address - Phone:412-526-6398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-07
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1134691231OtherINDIVIDUAL NPI