Provider Demographics
NPI:1609459163
Name:INTEGRATED WELLBEING LLC
Entity Type:Organization
Organization Name:INTEGRATED WELLBEING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN, IFMCP
Authorized Official - Phone:239-220-0288
Mailing Address - Street 1:325 NE 30TH ST
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-6891
Mailing Address - Country:US
Mailing Address - Phone:239-220-0288
Mailing Address - Fax:239-345-9595
Practice Address - Street 1:325 NE 30TH ST
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-6891
Practice Address - Country:US
Practice Address - Phone:239-220-0288
Practice Address - Fax:239-345-9595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty