Provider Demographics
NPI:1063866416
Name:CHOOSE HEALTH NUTRITION LLP
Entity Type:Organization
Organization Name:CHOOSE HEALTH NUTRITION LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNAE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERESFORD
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:803-608-4748
Mailing Address - Street 1:830 WALTERS LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29209-2339
Mailing Address - Country:US
Mailing Address - Phone:803-608-4748
Mailing Address - Fax:803-470-3717
Practice Address - Street 1:830 WALTERS LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-2339
Practice Address - Country:US
Practice Address - Phone:803-608-4748
Practice Address - Fax:803-470-3717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-21
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1218133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty