Provider Demographics
NPI:1083151526
Name:NUTRITION, LLC
Entity Type:Organization
Organization Name:NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEWITT
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:256-289-1845
Mailing Address - Street 1:347 WATERS EDGE LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-2561
Mailing Address - Country:US
Mailing Address - Phone:256-289-1845
Mailing Address - Fax:
Practice Address - Street 1:347 WATERS EDGE LN
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-2561
Practice Address - Country:US
Practice Address - Phone:256-289-1845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL86050943133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty