Provider Demographics
NPI:1225094493
Name:PERSONAL NEWTRITION LLC
Entity Type:Organization
Organization Name:PERSONAL NEWTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:O'CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED DIETITIAN
Authorized Official - Phone:513-661-6391
Mailing Address - Street 1:3012 GLENMORE AVE
Mailing Address - Street 2:SUITE 14
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-2269
Mailing Address - Country:US
Mailing Address - Phone:513-661-6391
Mailing Address - Fax:513-661-6392
Practice Address - Street 1:3012 GLENMORE AVE
Practice Address - Street 2:SUITE 14
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-2269
Practice Address - Country:US
Practice Address - Phone:513-661-6391
Practice Address - Fax:513-661-6392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH804238133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty