Provider Demographics
NPI:1225807829
Name:ASSIMILATE NUTRITION
Entity Type:Organization
Organization Name:ASSIMILATE NUTRITION
Other - Org Name:PANHANDLE NUTRITION THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:HUTTO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LD, CNSC
Authorized Official - Phone:806-673-2833
Mailing Address - Street 1:9211 GARRISON CREEK DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-7897
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1901 MEDI PARK DR STE 222
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2107
Practice Address - Country:US
Practice Address - Phone:806-673-2833
Practice Address - Fax:806-216-6707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-22
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty