Provider Demographics
NPI:1700643996
Name:COMPREHENSIVE NUTRITION SOLUTIONS INC
Entity Type:Organization
Organization Name:COMPREHENSIVE NUTRITION SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELLISA
Authorized Official - Middle Name:
Authorized Official - Last Name:NYBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-359-1065
Mailing Address - Street 1:1417 N DUBUQUE AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-6402
Mailing Address - Country:US
Mailing Address - Phone:605-359-1065
Mailing Address - Fax:
Practice Address - Street 1:1417 N DUBUQUE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-6402
Practice Address - Country:US
Practice Address - Phone:605-359-1065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty