Provider Demographics
NPI:1477104024
Name:LOXLY WELLNESS LLC
Entity Type:Organization
Organization Name:LOXLY WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:OECHSLE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CDN
Authorized Official - Phone:203-645-1814
Mailing Address - Street 1:1021 BENHAM ST
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-1924
Mailing Address - Country:US
Mailing Address - Phone:203-645-1814
Mailing Address - Fax:
Practice Address - Street 1:1021 BENHAM ST
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-1924
Practice Address - Country:US
Practice Address - Phone:203-645-1814
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty