Provider Demographics
NPI:1649547019
Name:STRIVE NUTRITION CONSULTING, LLC
Entity type:Organization
Organization Name:STRIVE NUTRITION CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEITKUNAT
Authorized Official - Suffix:
Authorized Official - Credentials:MS RD CDE
Authorized Official - Phone:303-807-4522
Mailing Address - Street 1:200 S WILCOX ST # 150
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1913
Mailing Address - Country:US
Mailing Address - Phone:303-807-4522
Mailing Address - Fax:
Practice Address - Street 1:140 S WILCOX ST STE A
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1911
Practice Address - Country:US
Practice Address - Phone:303-807-4522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty