Provider Demographics
NPI:1356149207
Name:FUNCTIONAL NUTRITION INSTITUTE LLC
Entity type:Organization
Organization Name:FUNCTIONAL NUTRITION INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:LOHMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:518-588-6150
Mailing Address - Street 1:65 PROVENCAL RD UNIT 208
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-1390
Mailing Address - Country:US
Mailing Address - Phone:518-588-6150
Mailing Address - Fax:
Practice Address - Street 1:65 PROVENCAL RD UNIT 208
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-1390
Practice Address - Country:US
Practice Address - Phone:518-588-6150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty