Provider Demographics
NPI:1669613410
Name:MARQUETTE NUTRITION & FITNESS, LLC
Entity type:Organization
Organization Name:MARQUETTE NUTRITION & FITNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MARQUETTE
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD
Authorized Official - Phone:512-468-4338
Mailing Address - Street 1:6006 BLANCO RIVER PASS
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-2861
Mailing Address - Country:US
Mailing Address - Phone:512-468-4338
Mailing Address - Fax:
Practice Address - Street 1:8700 MANCHACA RD
Practice Address - Street 2:SUITE 402
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-5371
Practice Address - Country:US
Practice Address - Phone:512-468-4338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-07
Last Update Date:2009-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT06469133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty