Provider Demographics
NPI:1477448603
Name:BODY GRACE MEDICAL NUTRITION THERAPY PLLC
Entity type:Organization
Organization Name:BODY GRACE MEDICAL NUTRITION THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWENER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRADER
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LD
Authorized Official - Phone:702-371-5719
Mailing Address - Street 1:10620 SOUTHERN HIGHLANDS PKWY STE 110-423
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-4371
Mailing Address - Country:US
Mailing Address - Phone:702-371-5719
Mailing Address - Fax:
Practice Address - Street 1:732 S 6TH ST # 4612
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-6948
Practice Address - Country:US
Practice Address - Phone:702-371-5719
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty