Provider Demographics
NPI:1801661681
Name:THE GENE HACKER
Entity type:Organization
Organization Name:THE GENE HACKER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRONTE
Authorized Official - Middle Name:
Authorized Official - Last Name:GROOMS
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:801-389-9919
Mailing Address - Street 1:2478 WILLAMETTE ALY
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-3142
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2478 WILLAMETTE ALY
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-3142
Practice Address - Country:US
Practice Address - Phone:801-389-9919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty