Provider Demographics
NPI:1134697071
Name:THE LIGHTER WEIGH
Entity Type:Organization
Organization Name:THE LIGHTER WEIGH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARMAINE
Authorized Official - Middle Name:BLAKE
Authorized Official - Last Name:WOODE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-429-9152
Mailing Address - Street 1:PO BOX 16099
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-1662
Mailing Address - Country:US
Mailing Address - Phone:256-429-9152
Mailing Address - Fax:
Practice Address - Street 1:1 HOSPITAL DR SW STE 300
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3495
Practice Address - Country:US
Practice Address - Phone:256-429-9152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIABETES AND ENDOCRINE WELLNESS CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-08
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity MedicineGroup - Single Specialty