Provider Demographics
NPI:1164294302
Name:BATCHELDER, JUSTIN (RD, MS)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:BATCHELDER
Suffix:
Gender:M
Credentials:RD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6971 W LOUISIANA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-5505
Mailing Address - Country:US
Mailing Address - Phone:720-261-1576
Mailing Address - Fax:
Practice Address - Street 1:6971 W LOUISIANA AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-5505
Practice Address - Country:US
Practice Address - Phone:720-261-1576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered