Provider Demographics
NPI:1083477954
Name:NUTRITION SOLUTIONS CO. LLC
Entity Type:Organization
Organization Name:NUTRITION SOLUTIONS CO. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NUTRITIONIST, CEO
Authorized Official - Prefix:
Authorized Official - First Name:TENIA
Authorized Official - Middle Name:BRIANNE
Authorized Official - Last Name:BENGTSON
Authorized Official - Suffix:
Authorized Official - Credentials:CPHT, NUTRITIONIST
Authorized Official - Phone:720-403-6553
Mailing Address - Street 1:12108 MELODY DR APT 204
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2116
Mailing Address - Country:US
Mailing Address - Phone:720-403-6553
Mailing Address - Fax:
Practice Address - Street 1:1499 W 120TH AVE STE 110
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2719
Practice Address - Country:US
Practice Address - Phone:720-403-6553
Practice Address - Fax:720-710-1308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-02
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center