Provider Demographics
NPI:1255633236
Name:NUTRITION DIMENSIONS INC
Entity type:Organization
Organization Name:NUTRITION DIMENSIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:MCDANIEL
Authorized Official - Last Name:SLAUGHTER
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD, FADA, FACHE
Authorized Official - Phone:540-586-4111
Mailing Address - Street 1:2609 FANCY FARM RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-3363
Mailing Address - Country:US
Mailing Address - Phone:540-586-4111
Mailing Address - Fax:888-875-6054
Practice Address - Street 1:2609 FANCY FARM RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-3363
Practice Address - Country:US
Practice Address - Phone:540-586-4111
Practice Address - Fax:888-875-6054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-24
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT05674133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty