Provider Demographics
NPI:1346559804
Name:WELLNESS, NUTRITION, & EDUCATION, LLC.
Entity Type:Organization
Organization Name:WELLNESS, NUTRITION, & EDUCATION, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:MICHELETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-647-3750
Mailing Address - Street 1:53 DARBY ROAD
Mailing Address - Street 2:P. O. BOX 846
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-0846
Mailing Address - Country:US
Mailing Address - Phone:610-644-5870
Mailing Address - Fax:610-647-3751
Practice Address - Street 1:53 DARBY ROAD
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-0846
Practice Address - Country:US
Practice Address - Phone:610-644-5870
Practice Address - Fax:610-647-3751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003967133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty