Provider Demographics
NPI:1841684826
Name:HEALTHY WEIGHS NUTRITION CENTER, LLC
Entity type:Organization
Organization Name:HEALTHY WEIGHS NUTRITION CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GABE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNTSON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:218-779-1287
Mailing Address - Street 1:18711 445TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:EAST GRAND FORKS
Mailing Address - State:MN
Mailing Address - Zip Code:56721-9229
Mailing Address - Country:US
Mailing Address - Phone:218-779-9736
Mailing Address - Fax:
Practice Address - Street 1:801 PRINCETON ST
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58202-6099
Practice Address - Country:US
Practice Address - Phone:218-779-9736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-26
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND943554133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Single Specialty