Provider Demographics
NPI:1558828541
Name:NK FITNESS AND NUTRITION, LLC
Entity Type:Organization
Organization Name:NK FITNESS AND NUTRITION, LLC
Other - Org Name:NK FITNESS,LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NIJYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAFFO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-425-4213
Mailing Address - Street 1:86 JEFFERSON RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-7532
Mailing Address - Country:US
Mailing Address - Phone:614-425-4213
Mailing Address - Fax:
Practice Address - Street 1:10479 TAYLOR RD SW
Practice Address - Street 2:
Practice Address - City:ETNA
Practice Address - State:OH
Practice Address - Zip Code:43068-3252
Practice Address - Country:US
Practice Address - Phone:614-425-4213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-26
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty