Provider Demographics
NPI:1578833638
Name:INSPIRED WELLNESS SOLUTIONS, LLC
Entity Type:Organization
Organization Name:INSPIRED WELLNESS SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:508-614-9355
Mailing Address - Street 1:391 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-1683
Mailing Address - Country:US
Mailing Address - Phone:508-614-9355
Mailing Address - Fax:
Practice Address - Street 1:391 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:MA
Practice Address - Zip Code:02048-1683
Practice Address - Country:US
Practice Address - Phone:508-614-9355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty