Provider Demographics
NPI:1326447913
Name:NUTRITION HEALTHWORKS LLC
Entity Type:Organization
Organization Name:NUTRITION HEALTHWORKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:BARTON
Authorized Official - Last Name:CHILCOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-380-4655
Mailing Address - Street 1:172 WILLIAMSON RD UNIT 5205
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-5000
Mailing Address - Country:US
Mailing Address - Phone:704-562-8373
Mailing Address - Fax:704-680-6672
Practice Address - Street 1:736 BRAWLEY SCHOOL RD STE G
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-9283
Practice Address - Country:US
Practice Address - Phone:704-380-4655
Practice Address - Fax:704-680-6672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-19
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty