Provider Demographics
NPI:1861028920
Name:MARLEY NUTRITION AND FITNESS
Entity Type:Organization
Organization Name:MARLEY NUTRITION AND FITNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARNES
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:318-691-5108
Mailing Address - Street 1:7790 MEADOWBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-3612
Mailing Address - Country:US
Mailing Address - Phone:831-869-1510
Mailing Address - Fax:
Practice Address - Street 1:7790 MEADOWBROOK AVE
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-3612
Practice Address - Country:US
Practice Address - Phone:831-869-1510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty