Provider Demographics
NPI:1851991095
Name:SMART CHOICE NUTRITION
Entity Type:Organization
Organization Name:SMART CHOICE NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN CONSULTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:WHITFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN,LD
Authorized Official - Phone:912-381-0304
Mailing Address - Street 1:PO BOX 205
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:GA
Mailing Address - Zip Code:31534-0205
Mailing Address - Country:US
Mailing Address - Phone:912-381-0304
Mailing Address - Fax:
Practice Address - Street 1:1865 BEAR CREEK RD
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:GA
Practice Address - Zip Code:31535-4680
Practice Address - Country:US
Practice Address - Phone:191-238-1030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty