Provider Demographics
NPI:1831720796
Name:NUTRITION WORKS, LLC
Entity type:Organization
Organization Name:NUTRITION WORKS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:L
Authorized Official - Last Name:PEDERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:330-388-7894
Mailing Address - Street 1:9247 WINDSWEPT DR
Mailing Address - Street 2:
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-2552
Mailing Address - Country:US
Mailing Address - Phone:330-388-7894
Mailing Address - Fax:
Practice Address - Street 1:9417 BROADVIEW RD
Practice Address - Street 2:
Practice Address - City:BROADVIEW HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44147-2307
Practice Address - Country:US
Practice Address - Phone:330-388-7894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty