Provider Demographics
NPI:1225557630
Name:EAT SMART FOR LIFE
Entity Type:Organization
Organization Name:EAT SMART FOR LIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:REMINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD RD CDE
Authorized Official - Phone:775-247-3981
Mailing Address - Street 1:316 CALIFONIA AVE
Mailing Address - Street 2:#1160
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509
Mailing Address - Country:US
Mailing Address - Phone:775-636-4420
Mailing Address - Fax:
Practice Address - Street 1:1325 AIRMOTIVE WAY STE 175
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3286
Practice Address - Country:US
Practice Address - Phone:775-636-4420
Practice Address - Fax:844-879-1888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-18
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV32025DI-0133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty