Provider Demographics
NPI:1578920294
Name:BAMR BANDS
Entity Type:Organization
Organization Name:BAMR BANDS
Other - Org Name:BAMR CONSULTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGISTERED DIETITIAN / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:HEDDLESTON
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:814-931-9961
Mailing Address - Street 1:812 WOODFIELD TER NE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-6674
Mailing Address - Country:US
Mailing Address - Phone:814-931-9961
Mailing Address - Fax:
Practice Address - Street 1:812 WOODFIELD TER NE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-6674
Practice Address - Country:US
Practice Address - Phone:814-931-9961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-26
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA995420133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty