Provider Demographics
NPI:1215551742
Name:EAT WELL LLC
Entity Type:Organization
Organization Name:EAT WELL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-210-2644
Mailing Address - Street 1:216 E FILBERT ST
Mailing Address - Street 2:
Mailing Address - City:EAST ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14445-1512
Mailing Address - Country:US
Mailing Address - Phone:703-405-0949
Mailing Address - Fax:
Practice Address - Street 1:216 E FILBERT ST
Practice Address - Street 2:
Practice Address - City:EAST ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14445-1512
Practice Address - Country:US
Practice Address - Phone:585-210-2644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-01
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty