Provider Demographics
NPI:1972205581
Name:EAT FOR WELLNESS CORPORATION
Entity Type:Organization
Organization Name:EAT FOR WELLNESS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-730-0065
Mailing Address - Street 1:42 LITTLE SORREL DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:VA
Mailing Address - Zip Code:22645-3982
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:42 LITTLE SORREL DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:VA
Practice Address - Zip Code:22645-3982
Practice Address - Country:US
Practice Address - Phone:806-730-0065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare