Provider Demographics
NPI:1417260407
Name:TELENUTRITION THERAPY INC
Entity Type:Organization
Organization Name:TELENUTRITION THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:706-951-8118
Mailing Address - Street 1:810 CAMELLIA RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-2734
Mailing Address - Country:US
Mailing Address - Phone:706-951-8118
Mailing Address - Fax:
Practice Address - Street 1:810 CAMELLIA RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-2734
Practice Address - Country:US
Practice Address - Phone:706-951-8118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty