Provider Demographics
NPI:1780446856
Name:NUTRI-BOL LLC
Entity type:Organization
Organization Name:NUTRI-BOL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:PADILLA
Authorized Official - Suffix:
Authorized Official - Credentials:MS RDN CSSD
Authorized Official - Phone:720-255-9470
Mailing Address - Street 1:834 S JOPLIN CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-3068
Mailing Address - Country:US
Mailing Address - Phone:720-255-9470
Mailing Address - Fax:
Practice Address - Street 1:8085 S CHESTER ST
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3543
Practice Address - Country:US
Practice Address - Phone:720-255-9470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports DieteticsGroup - Multi-Specialty