Provider Demographics
NPI:1417723370
Name:BRYTER LIFE NUTRITION LLC
Entity Type:Organization
Organization Name:BRYTER LIFE NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, REGISTERED DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:ALLISON
Authorized Official - Last Name:CAESAR
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:281-758-8789
Mailing Address - Street 1:21219 BARTON HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-6417
Mailing Address - Country:US
Mailing Address - Phone:281-758-8789
Mailing Address - Fax:832-363-5200
Practice Address - Street 1:1000 AUSTIN ST STE D
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-5275
Practice Address - Country:US
Practice Address - Phone:281-758-8789
Practice Address - Fax:832-363-5200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-30
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty