Provider Demographics
NPI:1922645217
Name:NUTRITIONAL LIVING, LLC
Entity Type:Organization
Organization Name:NUTRITIONAL LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/REGISTERED DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIODO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LDN, CHWC
Authorized Official - Phone:484-951-3916
Mailing Address - Street 1:809 WARREN RD
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-2206
Mailing Address - Country:US
Mailing Address - Phone:484-951-3916
Mailing Address - Fax:
Practice Address - Street 1:HORSHAM ATHLETIC CLUB
Practice Address - Street 2:400 HORSHAM ROAD
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044
Practice Address - Country:US
Practice Address - Phone:484-951-3916
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty