Provider Demographics
NPI:1164168803
Name:HOLLY LOCKHOFF NUTRITION
Entity Type:Organization
Organization Name:HOLLY LOCKHOFF NUTRITION
Other - Org Name:TIME TO THRIVE NUTRITION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOCKHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-937-2681
Mailing Address - Street 1:4211 LANDIS RD
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-1138
Mailing Address - Country:US
Mailing Address - Phone:610-937-2681
Mailing Address - Fax:
Practice Address - Street 1:165 MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:HARLEYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19438-2501
Practice Address - Country:US
Practice Address - Phone:484-854-3370
Practice Address - Fax:888-792-7497
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOLLY LOCKHOFF NUTRITION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-06
Last Update Date:2024-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty