Provider Demographics
NPI:1639935729
Name:MILITARY EATING RECOVERY
Entity Type:Organization
Organization Name:MILITARY EATING RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DYAL
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:585-449-0035
Mailing Address - Street 1:431 BROADWAY APT 609
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-3921
Mailing Address - Country:US
Mailing Address - Phone:430-558-9996
Mailing Address - Fax:
Practice Address - Street 1:2367 TACOMA AVE S OFC 212
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-1409
Practice Address - Country:US
Practice Address - Phone:585-449-0035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty