Provider Demographics
NPI:1568836484
Name:YOUR WELLNESS CONSULTANTS LLC
Entity Type:Organization
Organization Name:YOUR WELLNESS CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/REGISTERED DIETITIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:RICKARDS
Authorized Official - Suffix:JR
Authorized Official - Credentials:RD LDN
Authorized Official - Phone:215-431-8980
Mailing Address - Street 1:23 E BUTLER AVE
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-3023
Mailing Address - Country:US
Mailing Address - Phone:215-431-8980
Mailing Address - Fax:
Practice Address - Street 1:330 AMBER ST
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2305
Practice Address - Country:US
Practice Address - Phone:215-431-8980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-16
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty