Provider Demographics
NPI:1093352148
Name:CLIMB NUTRITION AND WELLNESS LLC
Entity Type:Organization
Organization Name:CLIMB NUTRITION AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:931-797-5019
Mailing Address - Street 1:104 W 7TH ST STE 7
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-3214
Mailing Address - Country:US
Mailing Address - Phone:931-240-4490
Mailing Address - Fax:
Practice Address - Street 1:104 W 7TH ST STE 7
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-3214
Practice Address - Country:US
Practice Address - Phone:931-240-4490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-09
Last Update Date:2019-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty