Provider Demographics
NPI:1508228313
Name:WATTS NUTRITION SERVICES, LLC
Entity Type:Organization
Organization Name:WATTS NUTRITION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WATTS
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:540-825-6973
Mailing Address - Street 1:101 DUKE ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-1511
Mailing Address - Country:US
Mailing Address - Phone:540-825-6973
Mailing Address - Fax:703-337-0502
Practice Address - Street 1:101 DUKE ST
Practice Address - Street 2:SUITE 203
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-1511
Practice Address - Country:US
Practice Address - Phone:540-825-6973
Practice Address - Fax:703-337-0502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service