Provider Demographics
NPI:1740882059
Name:POINT MODERN NUTRITION, PLLC
Entity type:Organization
Organization Name:POINT MODERN NUTRITION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:BRIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MESENBRING
Authorized Official - Suffix:
Authorized Official - Credentials:CNS, LDN
Authorized Official - Phone:815-953-6654
Mailing Address - Street 1:360 S CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRADLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60915-2112
Mailing Address - Country:US
Mailing Address - Phone:815-953-6654
Mailing Address - Fax:
Practice Address - Street 1:360 S CENTER AVE
Practice Address - Street 2:
Practice Address - City:BRADLEY
Practice Address - State:IL
Practice Address - Zip Code:60915-2112
Practice Address - Country:US
Practice Address - Phone:815-953-6654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-11
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty