Provider Demographics
NPI:1245095215
Name:TRUE POTENTIAL NUTRITION LLC
Entity type:Organization
Organization Name:TRUE POTENTIAL NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED DIETITIAN NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MACDOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:CNS, LDN
Authorized Official - Phone:781-532-1508
Mailing Address - Street 1:21 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MA
Mailing Address - Zip Code:02493-1563
Mailing Address - Country:US
Mailing Address - Phone:781-532-1508
Mailing Address - Fax:
Practice Address - Street 1:21 CENTER ST
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493-1563
Practice Address - Country:US
Practice Address - Phone:781-532-1508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty