Provider Demographics
NPI:1578610853
Name:NUTRITION MATTERS, LLC
Entity Type:Organization
Organization Name:NUTRITION MATTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED DIETITIAN
Authorized Official - Phone:810-245-4523
Mailing Address - Street 1:421 N MADISON ST
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-2029
Mailing Address - Country:US
Mailing Address - Phone:810-245-4523
Mailing Address - Fax:810-245-7686
Practice Address - Street 1:421 N MADISON ST
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-2029
Practice Address - Country:US
Practice Address - Phone:810-245-4523
Practice Address - Fax:810-245-7686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P20740Medicare ID - Type Unspecified