Provider Demographics
NPI:1558820316
Name:AMBER THOMAS NUTRITION AND WELLNESS LLC
Entity Type:Organization
Organization Name:AMBER THOMAS NUTRITION AND WELLNESS LLC
Other - Org Name:CANCER NUTRITION SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/RD NUTRITION THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:C
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:720-805-1600
Mailing Address - Street 1:1777 S HARRISON ST STE 1200
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3955
Mailing Address - Country:US
Mailing Address - Phone:720-805-1600
Mailing Address - Fax:720-805-1601
Practice Address - Street 1:1777 S HARRISON ST STE 1200
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3955
Practice Address - Country:US
Practice Address - Phone:720-805-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-19
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO897519OtherREGISTERED DIETITIAN LICENSE